Can PBMs Keep Their Lofty GLP-1 Cost Control Promises?

  • Mar 14, 2024

    As demand for GLP-1s has grown, so has the desire of plan sponsors and other payers to avoid covering the costly drugs as "lifestyle" products — instead, they want to allow only patients who will derive clear medical benefits from GLP-1s to use them. To address that desire, vertically integrated payer-PBMs, among other vendors, have launched buy-up services for commercial plan sponsors that promise to curb demand for GLP-1s by making other weight loss care more available to patients.

    Experts say it’s not clear whether those programs will make a difference for patients — or be worth the money for payers.

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