Eli Lilly launches program to boost employer coverage of obesity drugs

Eli Lilly on Thursday launched a new program designed to help more employers cover obesity drugs in the U.S., targeting a major barrier to access for patients. 

Lilly and its chief rival, Novo Nordisk, have moved to slash the cash prices of their popular obesity injections for those who want to pay entirely out-of-pocket. But employer coverage of obesity drugs remains uneven due to high costs, leaving roughly half of people with commercial insurance unable to start or stay on treatment, Lilly said in a release. List prices for Lilly’s weight loss and diabetes treatments, Zepbound and Mounjaro, top $1,000 per month.

Nearly one-fifth of firms with over 200 workers, including 43% with 5,000 or more workers, said they cover GLP-1 drugs for weight loss as of October, according to a survey by the Peterson-KFF Health System Tracker.

“I think we’ll learn in the coming months ahead, if this is a solution that maybe enables some employers who have been sitting on the sidelines to opt into obesity coverage for their employees,” Kevin Hern, senior vice president of Lilly Employer, said in an interview. He added that some employers could opt to add coverage in the upcoming months, while others could wait until 2027.

Eli Lilly’s new “Employer Connect” platform gives employers more flexibility in how they cover obesity treatments, aiming to broaden employee access to the drugs at low out-of-pocket costs, while also limiting expenses for companies. Hern said the program addresses some of the “core tensions” for employers when considering coverage of obesity drugs, including transparency around drug prices, flexibility in benefits design and the ability to choose among independent administrators.

Through the program, employers can pay a net discounted price of $449 per month for a new multi-dose form of Zepbound across all doses, Hern said. He added that the arrangement does not involve rebates, and that the net price gives employers clearer visibility to determine whether they can offer the drug.

Instead of relying on traditional benefit designs, employers can use Lilly’s platform to connect with more than a dozen different third-party program administrators that help manage obesity treatment benefits and costs. 

“Every employer is different. They all want to design things according to their unique needs and workforce,” Hern said.

Employers can choose among the 15 administrators to design benefits that fit their budget and workers’ needs. Some of the administrators may focus on administering the obesity benefits to employees, dealing with core functions such as enrollment, eligibility, claims and more. Other administrators may specialize in comprehensive obesity management, offering telehealth, nutrition and lifestyle support for patients. 

Lilly plans to expand the number of program administrators on the platform, which already include GoodRx, Mark Cuban’s Cost Plus Drug Company, Sesame, Teladoc Health, 9amHealth, Andel, Calibrate Health, Crux Health, eMed, FlyteHealth, Form Health, Goodpath, Ilant Health, Onsera Health, ReviveHealth, SALTA Direct Primary Care, Transcarent and Waltz Health.

“Our goal was to kind of create a platform where these firms could compete … with the value of their services for the employers,” Hern said. All of the administrators are offering the same medicine at the same price, so employers will determine “who can provide me the best service in terms of administering this program as I define that.”

Those with government insurance could also see easier access to obesity drugs: Under landmark deals that Lilly and Novo struck with President Donald Trump, Medicare will cover those medicines for the very first time later this year.