The surge in demand for GLP-1 medications has placed a significant financial strain on employers. While these medications offer promising results for weight loss and other conditions, their high cost necessitates a strategic approach to coverage. Here are five actionable steps to optimize your GLP-1 strategy and mitigate costs in 2025 and beyond:
Establishing clear, evidence-based criteria for GLP-1 coverage is crucial. This includes implementing robust enrollment verification processes to ensure that these medications are prescribed only to individuals with true clinical need. By requiring thorough documentation and verification, you can prevent unnecessary prescriptions and ensure that GLP-1s are reserved for those who will benefit most.
Your pharmacy benefit manager (PBM) plays a critical role in managing GLP-1 costs. Leverage your negotiating power to secure favorable pricing, rebates, and formulary options.
GLP-1s are most effective when combined with comprehensive behavior support. Partnering with a weight management provider is essential to provide a holistic approach for employees. Look for a partner that offers personalized coaching (by obesity-trained specialists) to help overcome social challenges, nutritional guidance for mitigating side effects, education on strength training to maintain muscle mass, and behavior modification strategies for long-term success. This wraparound approach helps optimize GLP-1 efficacy, promote adherence, and foster sustainable lifestyle changes.
Consider implementing tiered coverage and cost-sharing structures to incentivize participation in comprehensive weight management programs. Offer lower cost-sharing for employees who actively engage in wraparound programs and demonstrate adherence to their treatment plans. This approach encourages responsible utilization of GLP-1s and promotes long-term behavior change.
Prevention is key to long-term cost containment. You can address the factors that contribute to weight gain by investing in proactive benefits. This includes programs focused on nutrition, physical activity, stress management, and overall wellness education. By empowering employees to make healthy lifestyle choices, you can help reduce the demand for GLP-1s and improve the overall health of your workforce.
For employers who have chosen not to cover GLP-1s, implementing cost-effective alternatives is essential to promoting weight health among your employee population. By focusing on comprehensive weight management programs and preventive initiatives, you can effectively address the needs of your employees while managing healthcare costs.
Partner with a reputable weight management provider that offers evidence-based programs focused on behavior change. Look for programs that include personalized coaching, nutritional guidance, and physical activity support. These programs should empower employees to make sustainable changes and achieve lasting weight loss. For employees who are paying for GLP-1s out of pocket, a behavior change program can support adherence and long-term success.
Explore alternative formulary options and investigate the potential for partial coverage of manufacturer direct GLP-1 medications, while always prioritizing access, patient safety and efficacy.
Create a culture of wellness by implementing engaging programs that incentivize participation in healthy lifestyle initiatives. Offer rewards, recognition, and friendly competition to encourage employees to adopt healthy habits. By fostering a supportive and motivating environment, you can increase program engagement and improve employee health outcomes.
Invest in preventive programs that address the root causes of weight-related health issues, such as poor nutrition, lack of activity, and chronic stress. Registered Dieticians can provide one-on-one, personalized guidance. By empowering employees to make healthy choices, you can reduce the risk of chronic disease and help employees achieve their weight management goals.
Whether you're covering GLP-1s or exploring alternative strategies, a comprehensive and proactive approach to weight management is paramount. WeightWatchers is committed to partnering with you to develop tailored solutions that meet your unique needs and those of your population. By combining evidence-based programs, personalized support, and innovative technology, we empower employees to achieve lasting health improvements and reduce healthcare costs. We meet employers where they are, and provide the correct tools for success, no matter if they are covering GLP-1s or choosing a different path.
Learn more about how we can help you navigate the rising costs of weight management and create a healthier workforce.