A year ago, most employers covering GLP-1s for weight loss relied on prior authorization alone. That's changed fast. Peterson-KFF reported that 34% of employers covering GLP-1s for weight loss now require participation in a lifestyle program — up from 10% the year before. Brown & Brown's employer survey found that 38% require lifestyle program participation,…
Tag: Metabolic Health
Your GLP-1 Strategy Covers a Fraction of the Employees Who Need Help. What About the Rest?
The math reveals an uncomfortable truth: GLP-1 utilization tells only part of the metabolic health story. New analysis from the Peterson-KFF Health System Tracker examined GLP-1 utilization patterns across employer-sponsored insurance plans. The headline finding: 15% of covered adults used a GLP-1 in 2023. But with 42% of U.S. adults meeting obesity criteria, a significant…
What the Evidence Says About Weight Management Programs That Actually Last
The GLP-1 durability conversation has established something important: medication alone doesn't produce lasting weight management outcomes for most patients. The Oxford BMJ meta-analysis (West et al., 2026) documented regain roughly 4x faster after stopping GLP-1s than after behavioral interventions. CMS is designing its BALANCE Model around the same concern — pairing drug access with lifestyle…
Your CFO Is Asking About GLP-1 Costs. Here’s How to Frame the Conversation.
Your CFO has seen the pharmacy numbers. The conversation is coming — if it hasn't already. GLP-1 spend is up. In some plans, it's among the fastest-growing pharmacy line items. And the questions you're getting aren't about the clinical evidence anymore. They're about the budget. Why are we paying this much? Is it going to…
This Week in Employer Health — April 06
Novo Nordisk launched Wegovy HD (semaglutide 7.2 mg) nationwide last week — the highest-dose Wegovy injection to date. In the STEP UP trial (Wharton et al., Lancet Diabetes Endocrinol, 2025), patients on the 7.2 mg dose lost an average of 20.7% of their body weight over 72 weeks, compared to 17.5% on the existing 2.4…
What Employers Can Learn From CMS’s New GLP-1 Coverage Model
In December 2025, CMS announced the BALANCE Model — Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth. The name is bureaucratic. The design choice behind it is not. The model enables Medicare Part D plans and state Medicaid agencies to cover GLP-1 medications for weight management. What makes it notable isn't just the expanded…
Foundayo Lowers the Friction on GLP-1 Access. Here’s What Employers Should Watch.
The FDA yesterday approved Foundayo (orforglipron), Eli Lilly's oral GLP-1 for weight loss. It's the second daily GLP-1 pill to reach the market, following Novo Nordisk's Wegovy pill in December 2025. For anyone tracking the GLP-1 landscape from an employer benefits perspective, this approval matters — not because of the drug itself, but because of…