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Private health insurers covered 112,000 fewer Mass. residents’ GLP
The Boston Globe • • business
Key Points:
- Major private insurers in Massachusetts, including Blue Cross Blue Shield and Point32Health, have ended blanket coverage of GLP-1 drugs for obesity, citing high costs, though coverage continues for diabetes and other conditions.
- These drugs, which reduce body weight by 15-25% on average after a year, are no longer widely covered for obesity, forcing some patients to pay out-of-pocket costs ranging from $150 to over $400 monthly or seek alternative telehealth options.
- Public insurers like MassHealth and the Group Insurance Commission have also limited GLP-1 coverage for weight loss, raising concerns about access and health equity for those unable to afford these medications privately.
- Insurers report improved financial results after reducing GLP-1 coverage for obesity, with spending on these drugs projected to decrease from nearly $1 billion in 2025 to $662 million in 2026.
- The GLP-1 market is rapidly evolving, with new drugs expected by 2030 and shifting sales models, including direct-to-consumer options that have pressured pharmaceutical companies to lower prices.
