HBF to slash rebates for weight loss drugs, including Ozempic: Policyholders disappointed

Western Australia’s largest private health insurer, HBF, has announced significant changes to its pharmaceutical benefits, with rebates for weight loss drugs set to be slashed from August. The insurer cited the unsustainable growth in claims for weight loss medications as the reason behind the decision.

HBF, which holds about 53 percent of all health insurance policies in the state, will cut benefits altogether for some medications, including Wegovy and certain compound medications. Additionally, rebates for other medications, such as those containing semaglutide, the active ingredient in Ozempic, will be halved.

The popularity of Ozempic as a weight loss drug has surged since its introduction in 2021, leading to worldwide shortages. Despite being prescribed “off-schedule” for weight loss purposes, the drug has been praised for its positive impact on patients’ health.

HBF’s chief executive, Lachlan Henderson, acknowledged the health benefits of the weight loss medications but emphasized the need to balance costs with benefits for both individuals and the community. He noted that the insurer pays out about $9 million a year for off-schedule pharmaceuticals, with weight loss drugs accounting for 40 percent of that spend.

Patients like Max, who have experienced significant health improvements with Ozempic, expressed disappointment over the rebate cuts. Max described his life-changing weight loss journey with the drug, highlighting improvements in his BMI, sleep quality, and overall well-being.

Despite the reduced rebates, Max emphasized the importance of access to Ozempic for his health and well-being. He raised concerns about the impact of the changes on his weight and appetite, underscoring the value of health insurance in supporting members’ health goals.

The decision by HBF to cut rebates for weight loss drugs has sparked debate among policyholders, with many questioning the rationale behind the changes. As the August implementation date approaches, patients and healthcare providers are closely monitoring the impact of the decision on access to vital medications for weight management.