3 Things Employers Should Know Before Covering GLP-1s for Their Workforce  

Short on time? Here’s what you need to know: 

• GLP-1 coverage is no longer a nice-to-have: both prospective and current employees expect it, and a third will go elsewhere without it. Yet the barriers to entry for employers appear high on paper. 

• Adopting provider-led programs, improving member education, and developing effective member marketing strategies can help employers manage the clinical and financial implications of GLP-1 coverage. 

• An onsite wellness center with integrated types of care through Premise Health sets employers up with the tools to implement smarter GLP-1 management for their organizations. 

If you’re an employer considering making GLP-1s more accessible to your workforce, you’re not alone. In 2024, 57% of U.S. employers provided coverage of GLP-1s for diabetes, and over a third also covered them for weight loss. These numbers are expected to continue increasing as organizations try to meet demand; 73% of Americans now say GLP-1 coverage is important for taking or staying at a job, and 31% would change jobs just to get coverage. 

However, there are many factors to consider before making the leap: do you have the right support programs in place? Are you prepared for the potential impact to your pharmacy spend management? In this blog, we’ll give you insight on what to expect when offering GLP-1s to your workforce, and what you can do to avoid pitfalls many organizations are now trying to retroactively solve for. 

#1: GLP-1s are still expensive, but there’s a smarter (and healthier) way to mitigate the impact 

The numbers don’t lie: the per member per month cost of GLP-1s rose from $1.50 in 2019 to over $11 in 2023, marking more than a 600% increase. This can be jarring for employers weighing the ROI of GLP-1 drugs, especially when their premiums could increase as by as much as 14 percent using real-world cost scenarios. The good news is, while long term outcomes and ROI data are still emerging, early studies are looking promising; members using GLP-1s are showing improved health outcomes, lowering the growth rate of medical costs over two years. But how can you make sure you stay on the positive side of the investment while also protecting the health of your members?  

Offering GLP-1 coverage through provider-led programs that bring together primary care providers (PCPs), pharmacists, dietitians and care managers helps curb costs and improve health outcomes. In 2022, over 37% of GLP-1 prescriptions were written without a proper overweight, obesity, or diabetes diagnosis. This means that a large portion of GLP-1 users had not been formally approved by a licensed provider to access the medication, resulting in higher cost for both parties and decreased access for members with high-risk conditions.  

Provider-led programs help promote clinically appropriate prescribing by limiting access to members who are under the guidance and care of a team of providers. The PCP can advise on prescribing and overall health needs, the pharmacist can support medication access for the member, and the care manager or dietitian are there for regular check ins and additional coaching. When only clinically appropriate members are on GLP-1s, they become less expensive, and high-risk members have a better chance of getting healthier. 

Remember, coverage doesn’t have to be all or nothing either. Many employers only offer GLP-1s for members managing diabetes, or as part of an integrated weight management program as opposed to just general weight loss. Not every plan will look the same, so it’s important to consider what will work for your specific population. 

#2: GLP-1s are a long-term solution, not a quick-fix 

When prescribed properly, GLP-1s require ongoing use to maintain weight loss; it’s critical that both employers and their members think of them like true chronic condition management drugs, not short-term fixes. The media is a major part of the misconception that most weight management programs don’t work, positioning GLP-1s as a quick and effortless solution. The reality is: when members don’t see the magic results they’re looking for, 58% discontinue them before reaching meaningful levels of weight loss, which can then reverse much of their progress anyway. This drop in adherence creates a domino effect: the initial uptake in spend ends up yielding minimal health benefits for the member and potentially a negative ROI for the employer. So, what’s missing in this scenario? Member education. 

Offering member education at the point-of-care and lifestyle change support throughout the care journey helps members use GLP-1s properly. Many people don’t have experience with or are uncomfortable with injections or may even have unexpected side effects. Additionally, GLP-1s can be tricky, sometimes requiring changes in dosage to work properly. These are a few of the many reasons why it’s important for members to have the support of providers; they can ask questions, get advice they can trust, and feel confident continuing the medication.  

#3: A member marketing strategy is essential for a great member experience 

Even when employers may feel confident about the clinical and financial implications of offering GLP-1s, many overlook the operational realities that can impact member experience and plan performance. Sure, opening access to weight loss medication can improve recruiting and talent retention benefits, but there’s a lot that needs to happen behind the scenes. How will you design your benefits messaging to reduce member confusion or frustration on who qualifies, while also avoiding pitfalls like stigma? This is where a proactive, clear member marketing strategy comes into play. 

Transparent and consistent communication to your members regarding GLP-1 coverage can make all the difference. Employers should set member expectations as early and often as possible using plain language. Who qualifies for GLP-1 coverage based on what conditions? What’s the easiest way for them to see a provider for a consultation? Reinforcing the message at key touchpoints, like benefits communications, member portals, or at the point of care itself, can help members feel well-informed and empowered to consider their options. Providers that are dedicated to your population can also develop in-depth knowledge of your benefits plans and help members navigate coverage, something that community providers can’t offer.  

Smarter GLP-1 management at Premise Health 

Opting to cover GLP-1s for your workforce can seem complicated, but it doesn’t have to be. At Premise Health, we have the tools to help you implement the right strategies across your organization: 

• Direct healthcare model that’s primed to support members with an integrated weight management program 

• Lifestyle medicine approach that’s primary care-led, evidence-based, and supported by an interdisciplinary care team that can include integrated pharmacy support, behavioral health, nutrition, and more 

• Dedicated member marketing team to help design communication strategy and drive utilization of services 

• Offerings that are proven to help you save on healthcare cost while improving the member experience 

If you’re ready to see what smarter GLP-1 management looks like, register for our upcoming webinar on Thursday, April 9!