GLP-1s Serving as the Intersection of Cost, Utilization
Pharmaceutical Strategies Group experts joined Drug Topics to discuss the role GLP-1s play in drug benefit design.
With the rise in glucagon-like peptide-1 (GLP-1) use and expenditures, this medication class has the potential to serve as the exemplified intersection of health care costs and utilization. Serving as an example of supply and demand in benefits management, health plans’ treatment of GLP-1s and whether or not they are covered has been a significant topic of discussion in recent history.
“Payers [are] divided on coverage of GLP-1s for obesity,” according to the Pharmaceutical Strategies Group (PSG). “While almost all payers cover GLP-1s for diabetes, just 2 in 5 cover GLP-1s for obesity, and nearly half who don’t currently cover these drugs for obesity wouldn’t do so at any price.”
Drug Topics recently caught up with 2 representatives from PSG who contributed to the company’s 2025 Trends in Drug Benefit Design Report.
“GLP-1s really have been a once-in-a-lifetime moment for our payer clients,” said Scott Halperin, PharmD, senior pharmacy benefit clinical consultant of employer groups at PSG. “For years, the focus has been on specialty drug management, and now we're seeing a huge rise in non-specialty drug management and non-specialty drug costs. GLP-1s have really been the intersection of cost and utilization.”
Accompanied by Morgan Lee, PhD, MPH, CPH, PSG’s senior director of research and strategy, the duo explored the overall trends in GLP-1 use and how plan sponsors are acting on these trends. Watch the full video to see how drug benefits are adapting amid the rise in what many experts are calling life-saving medications.
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