5 Strategic Steps Plan Sponsors Can Take to Be Ready for GLP-1s

GLP-1s are on everyone’s minds and putting HR and benefits professionals in the hot seat. With obesity and weight loss treatments dominating healthcare conversations, plan sponsors are fielding tough questions from every direction about coverage, cost, and employee demand.

Here’s a five-step game plan to ensure plan sponsors build a thoughtful, proactive GLP-1 strategy.

1. Quantify the Demand in Your Population

Before making any decisions, assess how many employees are currently taking GLP-1s and how many might be eligible or interested—whether for diabetes or weight loss—based on BMI and comorbidities. The more granular your data, the better you can forecast utilization and manage future costs.

2. Evaluate Your PBM Relationship—But Don’t Panic

Now’s the time to do a deep dive into your current PBM program to find potential gaps in support or access. That involves analyzing formulary positioning and what prior authorization protocols exist, as well as rebate incentives.

While GLP-1 coverage alone isn’t a reason a plan sponsor switches PBMs, identifying potential gaps or friction points can help you determine whether additional support outside the plan is needed.

3. Choose—and Communicate—Your Coverage Framework

Once you understand the landscape, make a clear decision using clinical and financial logic: Will your plan cover GLP-1s for weight loss? If not, what are the alternative options for members?

Whatever you choose, communicate early and clearly to your members. They need to know what to expect and how to act to avoid any confusion. Poor communication and limited guidance will leave them feeling stressed and frustrated when they try to navigate the system.

4. Add Navigation Support

GLP-1s are expensive medications that aren’t the easiest to get, so many members don’t know where to start. Tools like Scripta’s GLP-1 Navigator are a game-changer, helping members understand their options and the trade-offs—regardless of whether their plan covers GLP-1s—including guidance around:

• Brand/formulation differences

• Delivery methods and side effects

• Cash pay vs. insurance options

• How to compare vendors, suppliers and prices

5. Stay Agile and Open to Innovation

This space is moving fast. What once felt like a mere consideration to your benefits strategy is now a baseline expectation. From Rx savings cards to cash pay alternatives, options are emerging to meet skyrocketing demand without breaking the bank.

Stay flexible, watch the market closely, and revisit your strategy often. This isn’t a “set it and forget it” kind of decision.

Final Thoughts

Whether you choose to cover GLP-1s or not, your decision-making framework matters. The goal isn’t just to control cost—it’s to empower employees with clear, compassionate, and informed support.

By following these steps, plan sponsors can prepare thoughtfully for the GLP-1 era and help their members make sense of it all.

Want more straight, honest answers to eliminate GLP-1 confusion? Watch our latest GLP-1 webinar – available now on demand – featuring Chief Medical Officer (Dr. Paul Bradley) and Chief Pharmacy Officer (Ferrin Williams). We covered everything from common missteps in GLP-1 use to what CVS dropping Zepbound means for your members—and what to do next.