GLP-1 Webinar for Employers and Brokers: Plan Strategy and Drug Coverage

What are GLP-1s?

Glucagon-like peptides-1 receptor agonists (GLP-1s) and Glucose-dependent Insulinotropic Polypeptide receptor agonists (GIP) are medications that mimic hormones naturally produced by the body. When referring to ‘GLP-1s', this includes GLP-1s and dual GLP-1s/GIPs. The Food and Drug Administration (FDA) has approved several GLP-1s to treat type 2 diabetes, obesity, and reduce the risk of cardiovascular disease.

What are the growth drivers of GLP-1s?

GLP-1 therapies, first approved in 2005, have been part of the pharmacy landscape for two decades. Recently, their demand has surged due to their benefits and FDA approvals for type 2 diabetes, weight management, obstrutive sleep apnea, a type of liver disease (MASH: Metabolic dysfunction-associated steatohepatitis) and reducing cardiovascular risks. GLP-1s are also being studied for treating various chronic diseases like heart failure, kidney disease, and Alzheimer’s disease. Their future growth is expected to continue, driven by their efficacy and safety, the rising prevalence of diabetes and obesity, and new FDA- approved indications, likely making them a significant driver of employer plan sponsors' pharmacy benefits spending.

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

Pharmaceutical Strategies Group (PSG) reported1 that nearly 80% of health plans and employers respondents were moderately or very concerned about the affordability of GLP-1s. According to the same PSG report, 91% of health plans and employers currently cover GLP-1s for type 2 diabetes, while 33% cover them for obesity.

How are plan sponsors managing the costs of GLP-1s for obesity?

According to a study by PSG2, the top cost containment strategies are prior authorization, Body Mass Index (BMI) requirement, quantity limits, comorbid condition requirement, step therapy, and lifestyle modification program participation requirement.

What is the SmithRx Weight Management Program?

The Weight Management Program tackles rising costs in this category by providing you and your members access to low-list price GLP-1s for weight management, paired with a member tailored approach. This weight management program partners with 9amHealth, a virtual telehealth clinic. Their providers connect members to coaching and lifestyle support, and also may prescribe weight loss medications. The program's primary goal is to provide a clinical-based, step-wise approach to get weight management medications to qualifying members.

Does program participation require a clinical review?

Yes, the 9amHealth clinical review for GLP-1s is a holistic and long-term process designed for sustainable obesity care. Their expert Care Team—including obesity specialists, pharmacists, and nutritionists—provides a personalized approach that goes beyond just looking at BMI (Body Mass Index). The team considers members’ full health profile, medical history, and lab values to create a treatment plan tailored specifically for them. While GLP-1s are a treatment option for eligible members, 9amHealth first prioritizes a cost-effective, step-therapy approach. This means they'll focus on essential lifestyle and behavioral changes, along with low-cost generic medications, before prescribing a GLP-1. The goal is to provide clinically appropriate care that is both effective and sustainable for members’ long-term health.

What are some of the benefits for members with 9amHealth?

Unlimited on-demand support from care team via text or chat or schedule video visit
Individualized goal setting with support from entire care team (physician, nurse, dietitian, etc)
Option for Smart Weight Scale device that is a connected cellularly to measure body weight
Virtual medication counseling and adherence with ongoing optimization assessment
Tailored meal plans with recipes driven by conditions, allergies, and eating preferences

What are GLP-1s?

Glucagon-like peptides-1 receptor agonists (GLP-1s) and Glucose-dependent Insulinotropic Polypeptide receptor agonists (GIP) are medications that mimic hormones naturally produced by the body. When referring to ‘GLP-1s', this includes GLP-1s and dual GLP-1s/GIPs. The Food and Drug Administration (FDA) has approved several GLP-1s to treat type 2 diabetes, obesity, and reduce the risk of cardiovascular disease.

What are the growth drivers of GLP-1s?

GLP-1 therapies, first approved in 2005, have been part of the pharmacy landscape for two decades. Recently, their demand has surged due to their benefits and FDA approvals for type 2 diabetes, weight management, obstrutive sleep apnea, a type of liver disease (MASH: Metabolic dysfunction-associated steatohepatitis) and reducing cardiovascular risks. GLP-1s are also being studied for treating various chronic diseases like heart failure, kidney disease, and Alzheimer’s disease. Their future growth is expected to continue, driven by their efficacy and safety, the rising prevalence of diabetes and obesity, and new FDA- approved indications, likely making them a significant driver of employer plan sponsors' pharmacy benefits spending.

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

Pharmaceutical Strategies Group (PSG) reported1 that nearly 80% of health plans and employers respondents were moderately or very concerned about the affordability of GLP-1s. According to the same PSG report, 91% of health plans and employers currently cover GLP-1s for type 2 diabetes, while 33% cover them for obesity.

How are plan sponsors managing the costs of GLP-1s for obesity?

According to a study by PSG2, the top cost containment strategies are prior authorization, Body Mass Index (BMI) requirement, quantity limits, comorbid condition requirement, step therapy, and lifestyle modification program participation requirement.

What is the SmithRx Weight Management Program?

The Weight Management Program tackles rising costs in this category by providing you and your members access to low-list price GLP-1s for weight management, paired with a member tailored approach. This weight management program partners with 9amHealth, a virtual telehealth clinic. Their providers connect members to coaching and lifestyle support, and also may prescribe weight loss medications. The program's primary goal is to provide a clinical-based, step-wise approach to get weight management medications to qualifying members.

Does program participation require a clinical review?

Yes, the 9amHealth clinical review for GLP-1s is a holistic and long-term process designed for sustainable obesity care. Their expert Care Team—including obesity specialists, pharmacists, and nutritionists—provides a personalized approach that goes beyond just looking at BMI (Body Mass Index). The team considers members’ full health profile, medical history, and lab values to create a treatment plan tailored specifically for them. While GLP-1s are a treatment option for eligible members, 9amHealth first prioritizes a cost-effective, step-therapy approach. This means they'll focus on essential lifestyle and behavioral changes, along with low-cost generic medications, before prescribing a GLP-1. The goal is to provide clinically appropriate care that is both effective and sustainable for members’ long-term health.

What are some of the benefits for members with 9amHealth?

Unlimited on-demand support from care team via text or chat or schedule video visit
Individualized goal setting with support from entire care team (physician, nurse, dietitian, etc)
Option for Smart Weight Scale device that is a connected cellularly to measure body weight
Virtual medication counseling and adherence with ongoing optimization assessment
Tailored meal plans with recipes driven by conditions, allergies, and eating preferences

What are GLP-1s?

Glucagon-like peptides-1 receptor agonists (GLP-1s) and Glucose-dependent Insulinotropic Polypeptide receptor agonists (GIP) are medications that mimic hormones naturally produced by the body. When referring to ‘GLP-1s', this includes GLP-1s and dual GLP-1s/GIPs. The Food and Drug Administration (FDA) has approved several GLP-1s to treat type 2 diabetes, obesity, and reduce the risk of cardiovascular disease.

What are the growth drivers of GLP-1s?

GLP-1 therapies, first approved in 2005, have been part of the pharmacy landscape for two decades. Recently, their demand has surged due to their benefits and FDA approvals for type 2 diabetes, weight management, obstrutive sleep apnea, a type of liver disease (MASH: Metabolic dysfunction-associated steatohepatitis) and reducing cardiovascular risks. GLP-1s are also being studied for treating various chronic diseases like heart failure, kidney disease, and Alzheimer’s disease. Their future growth is expected to continue, driven by their efficacy and safety, the rising prevalence of diabetes and obesity, and new FDA- approved indications, likely making them a significant driver of employer plan sponsors' pharmacy benefits spending.

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

Pharmaceutical Strategies Group (PSG) reported1 that nearly 80% of health plans and employers respondents were moderately or very concerned about the affordability of GLP-1s. According to the same PSG report, 91% of health plans and employers currently cover GLP-1s for type 2 diabetes, while 33% cover them for obesity.

How are plan sponsors managing the costs of GLP-1s for obesity?

According to a study by PSG2, the top cost containment strategies are prior authorization, Body Mass Index (BMI) requirement, quantity limits, comorbid condition requirement, step therapy, and lifestyle modification program participation requirement.

What is the SmithRx Weight Management Program?

The Weight Management Program tackles rising costs in this category by providing you and your members access to low-list price GLP-1s for weight management, paired with a member tailored approach. This weight management program partners with 9amHealth, a virtual telehealth clinic. Their providers connect members to coaching and lifestyle support, and also may prescribe weight loss medications. The program's primary goal is to provide a clinical-based, step-wise approach to get weight management medications to qualifying members.

Does program participation require a clinical review?

Yes, the 9amHealth clinical review for GLP-1s is a holistic and long-term process designed for sustainable obesity care. Their expert Care Team—including obesity specialists, pharmacists, and nutritionists—provides a personalized approach that goes beyond just looking at BMI (Body Mass Index). The team considers members’ full health profile, medical history, and lab values to create a treatment plan tailored specifically for them. While GLP-1s are a treatment option for eligible members, 9amHealth first prioritizes a cost-effective, step-therapy approach. This means they'll focus on essential lifestyle and behavioral changes, along with low-cost generic medications, before prescribing a GLP-1. The goal is to provide clinically appropriate care that is both effective and sustainable for members’ long-term health.

What are some of the benefits for members with 9amHealth?

Unlimited on-demand support from care team via text or chat or schedule video visit
Individualized goal setting with support from entire care team (physician, nurse, dietitian, etc)
Option for Smart Weight Scale device that is a connected cellularly to measure body weight
Virtual medication counseling and adherence with ongoing optimization assessment
Tailored meal plans with recipes driven by conditions, allergies, and eating preferences

What are GLP-1s?

Glucagon-like peptides-1 receptor agonists (GLP-1s) and Glucose-dependent Insulinotropic Polypeptide receptor agonists (GIP) are medications that mimic hormones naturally produced by the body. When referring to ‘GLP-1s', this includes GLP-1s and dual GLP-1s/GIPs. The Food and Drug Administration (FDA) has approved several GLP-1s to treat type 2 diabetes, obesity, and reduce the risk of cardiovascular disease.

What are the growth drivers of GLP-1s?

GLP-1 therapies, first approved in 2005, have been part of the pharmacy landscape for two decades. Recently, their demand has surged due to their benefits and FDA approvals for type 2 diabetes, weight management, obstrutive sleep apnea, a type of liver disease (MASH: Metabolic dysfunction-associated steatohepatitis) and reducing cardiovascular risks. GLP-1s are also being studied for treating various chronic diseases like heart failure, kidney disease, and Alzheimer’s disease. Their future growth is expected to continue, driven by their efficacy and safety, the rising prevalence of diabetes and obesity, and new FDA- approved indications, likely making them a significant driver of employer plan sponsors' pharmacy benefits spending.

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

Pharmaceutical Strategies Group (PSG) reported1 that nearly 80% of health plans and employers respondents were moderately or very concerned about the affordability of GLP-1s. According to the same PSG report, 91% of health plans and employers currently cover GLP-1s for type 2 diabetes, while 33% cover them for obesity.

How are plan sponsors managing the costs of GLP-1s for obesity?

According to a study by PSG2, the top cost containment strategies are prior authorization, Body Mass Index (BMI) requirement, quantity limits, comorbid condition requirement, step therapy, and lifestyle modification program participation requirement.

What is the SmithRx Weight Management Program?

The Weight Management Program tackles rising costs in this category by providing you and your members access to low-list price GLP-1s for weight management, paired with a member tailored approach. This weight management program partners with 9amHealth, a virtual telehealth clinic. Their providers connect members to coaching and lifestyle support, and also may prescribe weight loss medications. The program's primary goal is to provide a clinical-based, step-wise approach to get weight management medications to qualifying members.

Does program participation require a clinical review?

Yes, the 9amHealth clinical review for GLP-1s is a holistic and long-term process designed for sustainable obesity care. Their expert Care Team—including obesity specialists, pharmacists, and nutritionists—provides a personalized approach that goes beyond just looking at BMI (Body Mass Index). The team considers members’ full health profile, medical history, and lab values to create a treatment plan tailored specifically for them. While GLP-1s are a treatment option for eligible members, 9amHealth first prioritizes a cost-effective, step-therapy approach. This means they'll focus on essential lifestyle and behavioral changes, along with low-cost generic medications, before prescribing a GLP-1. The goal is to provide clinically appropriate care that is both effective and sustainable for members’ long-term health.

What are some of the benefits for members with 9amHealth?

Unlimited on-demand support from care team via text or chat or schedule video visit
Individualized goal setting with support from entire care team (physician, nurse, dietitian, etc)
Option for Smart Weight Scale device that is a connected cellularly to measure body weight
Virtual medication counseling and adherence with ongoing optimization assessment
Tailored meal plans with recipes driven by conditions, allergies, and eating preferences

What are GLP-1s?

Glucagon-like peptides-1 receptor agonists (GLP-1s) and Glucose-dependent Insulinotropic Polypeptide receptor agonists (GIP) are medications that mimic hormones naturally produced by the body. When referring to ‘GLP-1s', this includes GLP-1s and dual GLP-1s/GIPs. The Food and Drug Administration (FDA) has approved several GLP-1s to treat type 2 diabetes, obesity, and reduce the risk of cardiovascular disease.

What are the growth drivers of GLP-1s?

GLP-1 therapies, first approved in 2005, have been part of the pharmacy landscape for two decades. Recently, their demand has surged due to their benefits and FDA approvals for type 2 diabetes, weight management, obstrutive sleep apnea, a type of liver disease (MASH: Metabolic dysfunction-associated steatohepatitis) and reducing cardiovascular risks. GLP-1s are also being studied for treating various chronic diseases like heart failure, kidney disease, and Alzheimer’s disease. Their future growth is expected to continue, driven by their efficacy and safety, the rising prevalence of diabetes and obesity, and new FDA- approved indications, likely making them a significant driver of employer plan sponsors' pharmacy benefits spending.

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

Pharmaceutical Strategies Group (PSG) reported1 that nearly 80% of health plans and employers respondents were moderately or very concerned about the affordability of GLP-1s. According to the same PSG report, 91% of health plans and employers currently cover GLP-1s for type 2 diabetes, while 33% cover them for obesity.

How are plan sponsors managing the costs of GLP-1s for obesity?

According to a study by PSG2, the top cost containment strategies are prior authorization, Body Mass Index (BMI) requirement, quantity limits, comorbid condition requirement, step therapy, and lifestyle modification program participation requirement.

What is the SmithRx Weight Management Program?

The Weight Management Program tackles rising costs in this category by providing you and your members access to low-list price GLP-1s for weight management, paired with a member tailored approach. This weight management program partners with 9amHealth, a virtual telehealth clinic. Their providers connect members to coaching and lifestyle support, and also may prescribe weight loss medications. The program's primary goal is to provide a clinical-based, step-wise approach to get weight management medications to qualifying members.

Does program participation require a clinical review?

Yes, the 9amHealth clinical review for GLP-1s is a holistic and long-term process designed for sustainable obesity care. Their expert Care Team—including obesity specialists, pharmacists, and nutritionists—provides a personalized approach that goes beyond just looking at BMI (Body Mass Index). The team considers members’ full health profile, medical history, and lab values to create a treatment plan tailored specifically for them. While GLP-1s are a treatment option for eligible members, 9amHealth first prioritizes a cost-effective, step-therapy approach. This means they'll focus on essential lifestyle and behavioral changes, along with low-cost generic medications, before prescribing a GLP-1. The goal is to provide clinically appropriate care that is both effective and sustainable for members’ long-term health.

What are some of the benefits for members with 9amHealth?

Unlimited on-demand support from care team via text or chat or schedule video visit
Individualized goal setting with support from entire care team (physician, nurse, dietitian, etc)
Option for Smart Weight Scale device that is a connected cellularly to measure body weight
Virtual medication counseling and adherence with ongoing optimization assessment
Tailored meal plans with recipes driven by conditions, allergies, and eating preferences

What Employers and Brokers Need to Know about GLP-1s

What Employers and Brokers Need to Know about GLP-1s

What Employers and Brokers Need to Know about GLP-1s

Take Control of Your GLP-1 Spend with Clinical Support

Take Control of Your GLP-1 Spend with Clinical Support

Take Control of Your GLP-1 Spend with Clinical Support

Take Control of Your GLP-1 Spend with Clinical Support

Access Low List Price GLP-1s

Access Low List Price GLP-1s

Access Low List Price GLP-1s

Access Low List Price GLP-1s

Holistic, Clinically-Informed Care

Holistic, Clinically-Informed Care

Holistic, Clinically-Informed Care

Holistic, Clinically-Informed Care

Proven Weight Loss Success

Proven Weight Loss Success

Proven Weight Loss Success

Proven Weight Loss Success

GLP-1 Resources

Building a Cost and Care-Conscious GLP-1 Program

Building a Cost and Care-Conscious GLP-1 Program

Building a Cost and Care-Conscious GLP-1 Program

Building a Cost and Care-Conscious GLP-1 Program

Common Cardiometabolic Diseases: Overview, Prevalence, and GLP-1 treatment Impact

Common Cardiometabolic Diseases: Overview, Prevalence, and GLP-1 treatment Impact

Common Cardiometabolic Diseases: Overview, Prevalence, and GLP-1 treatment Impact

Common Cardiometabolic Diseases: Overview, Prevalence, and GLP-1 treatment Impact

What Brokers and Employers Need to Know About GLP-1s

What Brokers and Employers Need to Know About GLP-1s

What Brokers and Employers Need to Know About GLP-1s

What Brokers and Employers Need to Know About GLP-1s

Building a Cost and Care-Conscious GLP-1 Program

Common Cardiometabolic Diseases: Overview, Prevalence, and GLP-1 treatment Impact

Meet the Experts:SmithRx Pharmacy Leadership Team

The GLP-1 Breakthrough: What it is, Why it Matters, and How to Drive Health Plan Savings

Frequently Asked Questions

What are GLP-1s?

What are the growth drivers of GLP-1s?

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

How are plan sponsors managing the costs of GLP-1s for obesity?

What is the SmithRx Weight Management Program?

Does program participation require a clinical review?

What are some of the benefits for members with 9amHealth?

What are GLP-1s?

What are the growth drivers of GLP-1s?

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

How are plan sponsors managing the costs of GLP-1s for obesity?

What is the SmithRx Weight Management Program?

Does program participation require a clinical review?

What are some of the benefits for members with 9amHealth?

What are GLP-1s?

What are the growth drivers of GLP-1s?

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

How are plan sponsors managing the costs of GLP-1s for obesity?

What is the SmithRx Weight Management Program?

Does program participation require a clinical review?

What are some of the benefits for members with 9amHealth?

What are GLP-1s?

What are the growth drivers of GLP-1s?

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

How are plan sponsors managing the costs of GLP-1s for obesity?

What is the SmithRx Weight Management Program?

Does program participation require a clinical review?

What are some of the benefits for members with 9amHealth?

What are GLP-1s?

What are the growth drivers of GLP-1s?

We know GLP-1s are popular, but how are employers and health plans companies responding to the demand?

How are plan sponsors managing the costs of GLP-1s for obesity?

What is the SmithRx Weight Management Program?

Does program participation require a clinical review?

What are some of the benefits for members with 9amHealth?

Sales and Business

Pharmacy and Provider Line

Member Help

Company

Resources

Connect

Awards

Sales and Business

Meet the Experts:
SmithRx Pharmacy Leadership Team

Frequently Asked   Questions