The rising popularity of new GLP-1 weight-loss drugs like Wegovy has brought the issue of weight management and its associated costs to the forefront. With obesity rates climbing and healthcare systems spending billions annually, innovative solutions are needed. Connecticut's Flyte program emerges as one such solution, aiming to provide comprehensive weight management while controlling costs.
The Context: Rising Costs and Limited Coverage
New GLP-1 weight-loss drugs, such as Novo Nordisk's Wegovy, have surged in popularity in recent months. However, the accessibility of these medications is limited by insurance coverage. Currently, Medicare does not cover weight-loss medications, and only 22% of employers offer coverage for these drugs, according to data from the International Foundation of Employee Benefit Plans. Even among insurers who do cover weight-loss drugs, many are setting up strict prior authorization requirements before patients can get the drugs. For example, the University of Michigan, which covers about 120,000 people, increased the copays in its health plan from $20 to $45 after spending almost $9 million for 1,076 members on the weight-loss drugs from July 2022 and June 2023. Copays will further increase to $75 on Jan. In North Carolina, the state health plan, which covers 750,000 employees, will no longer cover high-cost weight-loss drugs for new members starting Jan. 1, 2024.
Connecticut’s employee health plan has experienced a 50% year-over-year rise in spending on glucagon-like-peptide-1 agonists (GLP-1s) used to treat obesity, beginning in 2020. This increase in spending, coupled with the limited coverage and rising obesity rates, has prompted a search for alternative approaches.
Flyte Program: A Clinical Lifestyle Management Solution
In response to these challenges, Connecticut introduced a new clinical lifestyle management program called Flyte for state health plan members who want to take drugs such as Ozempic or Wegovy for weight loss. "I never considered getting rid of the drugs, but I also knew that the status quo was not going to work and we had to look at other options," said Connecticut Comptroller Sean Scanlon, who runs the state health plan, which covers 265,000 employees. The Flyte program, administered through Intellihealth, aims to provide a more comprehensive and cost-effective approach to weight management.
Program Structure and Offerings
The Benefit Funds are also partnering with FlyteHealth, a medical health- and weight-management program. FlyteHealth provides specialized, virtual weight loss services through a team of physicians, nurse practitioners, and dietitians. With FlyteHealth, you’ll have a medical care team, including physicians, nurse practitioners and registered dietitians, that will work with you to create a personalized care plan. This innovative program is a new path you can choose that uses the FlyteHealth mobile app to support your health journey. Emory continues to expand services to help employees succeed with GLP-1 medications and make long-term sustainable health changes. Their obesity specialists collaborate closely with Emory Healthcare providers to manage conditions related to weight and obesity.
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The Flyte program offers a range of services, including:
- Personalized treatment plans: Tailored to individual health history, lifestyle, and readiness to change.
- Behavior and lifestyle support: Focuses on building sustainable habits.
- Mobile app features: Tools for food, activity, and weight tracking.
- Virtual visits and messaging: Provides ongoing support from healthcare professionals.
- Healthy recipes: Customized to dietary preferences.
- Educational resources and wellness programs.
- Pharmacotherapy options: When appropriate.
Eligibility and Enrollment
Any employee looking to start a GLP-1 medication is encouraged to enroll with FlyteHealth, and those currently using a GLP-1 will need to transition to FlyteHealth by June 1, 2025. If you are already a patient of an Emory specialist in endocrinology, obesity medicine, or lifestyle medicine, then you can continue care with your provider. Employees and adult dependents (18+) enrolled in an Emory-sponsored Aetna health plan with a BMI of 30 or higher-or 27 or higher with a weight-related condition-are eligible. The highest BMI recorded is considered if you have met the normal BMI with the support of a GLP1.
To participate, individuals meet with a FlyteHealth physician who designs a personalized plan. Participants attend virtual check-ins with registered dietitians and nurse practitioners to monitor progress and address challenges. The FlyteHealth app provides access to tools, resources, and support to help individuals achieve lasting results.
Medication Coverage
Weight loss medications are only covered if prescribed by a FlyteHealth provider or an approved Emory Healthcare provider specializing in endocrinology, obesity medicine, or lifestyle medicine. To learn more about Emory specialists' availability, contact the Emory EVIP at 404-778-3847. Current prescriptions remain valid until June 1, 2025. Starting June 2, 2025, refills will require a prescription from FlyteHealth or an approved Emory provider. For maintenance prescriptions for chronic conditions (e.g., high blood pressure, heart disease, asthma, diabetes, and birth control), you must use one of the following pharmacies for 90-day refills: CVS, Emory pharmacy, Target, Costco, Kroger, or select independent pharmacies. Attempting to fill prescriptions elsewhere will result in full retail costs.
Aetna POS plan: The POS Plan allows employees and adult dependents (18+) to receive services from the network of providers at no additional cost (labs cost will follow the plan parameters). Aetna HSA plan: All eligible expenses for you or your covered dependents apply toward the annual deductible and maximum out-of-pocket.
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If you choose not to engage with FlyteHealth or an approved Emory provider, you may still access weight loss medications, but they will not be covered under the employee health plan.
Early Results and Cost Considerations
So far, the Flyte program is showing early signs of success. As of Nov. 3, around 1,501 members of the state health plan have signed up for the program. Although doctors have written prescriptions for GLP-1 prescriptions for around 80% of these patients, the number of new prescriptions is plateauing. Connecticut currently pays around $110 a month for each participant in the program, and based on the current number of patients participating, the annual cost would be roughly $2 million.
Over the first six months of Flyte program, participants saw an average weight reduction of 10 percent, and an average Body Mass Index (BMI) reduction of 8.8 percent, according to a presentation by the Healthcare Cost Containment Committee. The average weight of those beginning in the program was 229 pounds with a BMI of 37.16, which is considered Class II obesity. The most dramatic weight loss occurred when patients were prescribed Ozempic and similar drugs like Wegovy, classified as GLP-1 drugs. “Right now, we are starting to see a flattening of the cost curve since the implementation of the Flyte program relative to GLP-1s. But use of Flyte appears to be taking off. There are currently 3,963 members of the state employee health plan enrolled in Flyte with a primary clinical goal of losing weight. “In addition to a flattening of the GLP-1 script growth for this population, we are looking for improvements in clinical outcomes for this population driven by clinically significant weight loss, which for higher risk members, will result in medium and long-term benefits for the plan and the members alike,” Csejka said.
FlyteHealth commissioned Milliman to independently analyze its initial observations on cost avoidance for the Connecticut employee health plan. In 2023, Connecticut partnered with FlyteHealth to launch a pilot of FlyteHealth’s comprehensive obesity care program. The program aimed to address rising costs associated with anti-obesity medications. This paper was commissioned by FlyteHealth.
The Future of Weight Management Programs
Other states and employers are already expressing interest in implementing programs like Connecticut's to help them control the costs of these weight-loss drugs. "We don't have a monopoly on good ideas in this world," Folwell said. "How much this strategy will take off will depend to some extent at what impact it has on cost, what impact it has on clinical outcomes and what impact it has on member satisfaction," Levin-Scherz said.
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As obesity rates continue to rise, so will healthcare costs. The Flyte program represents a proactive approach to managing these costs while providing comprehensive care to individuals seeking to improve their health. The program's focus on personalized treatment, lifestyle support, and ongoing monitoring offers a promising model for the future of weight management.