For employers, glucagon-like peptide-1 receptor agonists (GLP-1s) for obesity represent an unprecedented healthcare challenge. Employers are struggling to balance access to treatments that provide clinically meaningful outcomes with sustainable benefit design. Increasingly, employers are turning to virtual weight management solutions to help. 

This report is designed to be an employer purchasing guide for GLP-1 coverage and virtual solutions. It provides a framework to help employers evaluate emerging models and adopt clinically supported approaches.  

Based on analysis of employer experiences, vendor data, and expert interviews, PHTI outlines five key recommendations for employers: 

  1. Establish clear, clinically driven eligibility pathways for GLP-1 coverage 
  1. Require participation in behavior, nutrition, or lifestyle change programs as a condition of coverage 
  1. Provide structured support for employees who choose to taper or discontinue GLP-1 therapy 
  1. Review existing vendor capabilities before adding additional point solutions 
  1. Contract with vendors to drive outcomes while examining overall program costs 

The report identifies three critical phases where these solutions can support employers in managing their GLP-1 coverage: 

  • Initiation: Providing targeted GLP-1 coverage using clinical criteria, behavioral or AI-based screening, narrow prescribing networks, or step-therapy pathways that include lower-cost alternatives or lifestyle change programs.
  • Maintenance: Providing lifestyle coaching, nutritional guidance, symptom management, and proactive engagement to improve medication adherence and mitigate the discontinuation rates observed in real-world settings. 
  • Supported Discontinuation: Offering structured behavior, diet, and coaching to help individuals who choose to taper or discontinue therapy to maintain weight loss and prevent the rapid rebound that typically follows medication cessation.