Radar on Drug Benefits

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

  • Mar 14
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    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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    • Peter Johnson

    Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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View Lauren Flynn Kelly's Profile

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Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access

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Managing Editor, Health Plan Weekly and Radar on Drug Benefits

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Tim Casey

Reporter, Health Plan Weekly and Radar on Drug Benefits

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Carina Belles

Reporter, Radar on Medicare Advantage and Spotlight on Market Access

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PBMs/Pharmacy Benefit Managers
Employer Group Health Plans
Drug Pricing
Market Access
Benefit Management
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