Weight loss medications spike some counties' insurance rates, but Guernsey isn't affected

CAMBRIDGE − Just a few counties northwest, Richland is feeling the sting of rising drug and medical costs that has forced its budget into the red. One set of drugs has forced their hand. The cost of GLP-1 medications like Ozempic, Jardiance and Trulicity, typically used to treat Type 2 diabetes, has forced a massive increase in costs when they are prescribed to non-diabetic patients for weight loss.

Richland is now looking at cutting those medications when used for weight loss.

Guernsey County is “unaffected” by this trend, according to County Commissioner Dave Wilson, for two primary reasons.

“These medications are not a covered benefit (in Guernsey County) when prescribed for weight loss,” said Wilson. “They are only a covered benefit when the health plan member has been diagnosed with Type 2 diabetes. So, since these meds are not covered for any non-diabetes diagnosis, there has not been a spike in usage by our health plan members.”

He said given today’s environment of using these drugs for weight loss he understands the issue.

“Especially with the seemingly constant stream of advertising and weight loss related news coverage why some counties are seeing increases in prescription drug-related costs due to Ozempic and others within that medication category.”

He also noted that Guernsey County is not seeing increases because its medication contract is capped, preventing them from going out of budget.

“Our contract with the Pharmacy Benefit Manager (PBM) is capped at a fixed monthly amount over a two-year term,” said Wilson. “While the contract allows for an increase in year two, if indeed there is an increase, it cannot exceed 8.5 percent.”

Wilson said representatives from each of the Guernsey County offices whose employees are covered under its health plan meet monthly with its broker representatives.

“Those in attendance are updated on plan activity and its fiscal health,” said Wilson. “They are also actively involved in our annual renewal process and, in hindsight, made some very good decisions reflected in this year’s program. I’m happy to say that no changes are needed at this time.”

This article originally appeared on The Daily Jeffersonian: Weight loss medications spike some counties' insurance rates, but Guernsey isn't affected