A single drug can be approved for multiple conditions, but each new use requires its own clinical trials and regulatory approval, even if the drug is already approved for other indications, according to Suzanne Lepage, a private health plan strategist, during a session supported by Novo Nordisk at Benefits Canada’s 2025 Face to Face Drug Plan Management Forum.

GLP-1 drugs, such as semaglutide, help regulate blood sugar, hunger and inflammation. They’re being used for type 2 diabetes, weight management and cardiovascular risk reduction. (Wegovy, a brand name GLP-A, was approved by Health Canada for an additional indication — to treat a liver condition called metabolic dysfunction-associated steatohepatitis — on Dec. 10, 2025).

Read: How benefits plan sponsors, insurers are managing newer — and effective — GLP-1 medications

GLP-1 is a natural hormone that plays a key role in regulating weight, blood sugar, inflammation and various other bodily functions, noted Lepage. “GLP-1 treatments’ ability to affect multiple pathways has sparked significant interest and ongoing research in multiple health conditions.”

Experts, like Obesity Canada, have noted that obesity is a chronic disease, not a lifestyle choice, and is largely determined by genetics and biological factors, she added. While private drug plans have historically excluded obesity drugs, this is now changing as more payers and plan sponsors realize these medications can provide necessary support for plan members living with obesity.

Many plan sponsors are adding coverage, often with prior authorization requirements to ensure appropriate use, said Lepage, but some are continuing to exclude obesity treatments. Excluding a drug that treats obesity — but also has other indications, like GLP-1s — may also exclude it for all its other approved uses, she added, noting private plans require nuanced processes for drugs with multiple uses.

Read: 34% of U.S. employers covering GLP-1s for both diabetes, weight loss: survey

In addition, since current electronic drug claims processes lack details about what condition is being treated, prior authorization can ensure drugs are used appropriately for each approved indication, said Lepage. “However, prior authorization is typically manual and could benefit from greater automation.”

She suggested plan sponsors consider the legal and ethical implications around how drugs are covered by their plans. For example, she pointed to the increasing debate around why some conditions, such as obesity, are treated differently from others, like mental health or asthma, in benefits plans.

“Plan sponsors are encouraged to review their coverage for GLP-1 drugs and consider how they handle drugs with multiple indications.”

Read more coverage of the 2025 Face to Face Drug Plan Management Forum.