CarelonRx to Launch Digital Weight Management Program

CarelonRx will launch this spring a weight management program for members, including those who use GLP-1 medications. CarelonRx’s digital-first weight management program will provide access to digital coaching and wellness tools. Behavioral health and social drivers of health screenings will also be incorporated to ensure whole health is at the heart of personalized wellness plans.

The weight management program will be available to self-insured employers for whom Elevance Health administers medical and pharmacy benefits. CarelonRx is part of Elevance Health’s health services division. The program can be purchase by employers and is offered at no cost to members. The program cost for clients is based on the number of employees using the program, a CarelonRx spokesperson said.

Obesity is a common disease that is increasing. U.S. prevalence increased from 30.5% during the period 1999 to 2000 to 41.9% during the 2017 to March 2020, according to the CDC. Obesity-related conditions, such as heart disease, stroke, type 2 diabetes and certain types of cancer, are among the leading causes of preventable death. It's been predicted that by 2030, about half of adults in the United States will have obesity, and about a quarter of adults will have severe obesity, according to a study in the New England Journal of Medicine.

Drugs such as Wegovy (semaglutide), Saxenda (liraglutide) and the newest weight loss drug Zepbound (tirzepatide) activate receptors of hormones secreted from the intestine — glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) — to reduce appetite and food intake. These drugs have high costs, however. Wegovy and Saxenda have a list price of $1,349.02 per package. Zepbound, the newest GLP-1, launched with a list price of $1,059.87, although it is being offered to those without insurance for Zepbound for $550.

The CarelonRx program is for clients who are interested in providing a comprehensive weight loss solution for their employees. “The program has flexibility in which a client can offer the weight management program independent of their decision for coverage of GLP-1 medications,” a company spokesperson said. “The program is designed to support members who are and are not on GLP-1s for weight loss.”

Paul Marchetti

The program considers “member’s whole health needs, including pharmacy, medical and social drivers of health data, and creates opportunities for care coordination between nutrition and exercise experts, pharmacists, physicians and health plans,” Paul Marchetti, president of CarelonRx, said in a press release.

CarelonRx’s weight management program is not required for GLP-1 prescriptions.

Related: Optum Rx to Provide Weight Loss Management Program

CarelonRx is the latest company to provide such a program. Optum Rx began a program in January 2024, called Optum Rx Weight Engage, to weight management and wellness support to support employers, health plans and members.

Related: Capital Rx Partners with Virta Health for Diabetes, Obesity Patient Support

In July 2023, the PBM Capital Rx and Virta Health launched a similar program to provide members support for type 2 diabetes and obesity. Rx Reverse combines Capital Rx’s JUDI, the company’s pharmacy platform to unify pharmacy benefit management operations, with Virta’s solution – personalized nutrition counseling, remote monitoring and one-on-one coaching.

Analysis by both Prime Therapeutics and Omada Health/Express Scripts has shown patients require support to ensure continued use and lifestyle modification. Last year, a Prime analysis of real-world data found patients taking weight loss drugs such as Wegovy and Saxenda had low patient adherence and higher total cost of care.

More recently, an analysis that Omada conducted using Express Scripts’ pharmacy claims dated October 2022 through May 2023. The sample included Evernorth SafeGuardRx members participating in Omada for Prevention, a digital program for those at risk of developing type 2 diabetes. They found that members who used Wegovy and/or Saxenda and were more engaged in Omada for Prevention lost more weight than those who used these medications and were relatively less engaged in the program. The association was strongest for members who engaged with a coach or with other Omada members.