Eli Lilly On Thursday it launched a new program designed to help more employers cover obesity medications in the U.S., targeting a major barrier to access for patients.
Lilly and its main rival, Nordiskhave taken steps to reduce the cash prices of their popular anti-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 about half of people with commercial insurance unable to start or continue treatment, Lilly said in a statement. List prices for Lilly's diabetes and weight loss treatments, Zepbound and Mounjaro, top $1,000 a month.
Nearly one-fifth of companies with more than 200 workers, including 43% with 5,000 or more workers, said they covered GLP-1 weight-loss drugs in October, according to a survey by Peterson-KFF Health System Tracker.
“I think in the next few months we'll know if this is a solution that maybe allows some employers who have been on the sidelines to opt into obesity coverage for their employees,” Kevin Hern, senior vice president at Lilly Employer, said in an interview. He added that some employers could choose to add coverage in the coming months, while others could wait until 2027.
Eli Lilly's new “Employer Connect” platform offers employers more flexibility in how they cover obesity treatments, with the goal of expanding employee access to medications at low out-of-pocket costs, while limiting company expenses. hern said The program addresses some of the “core tensions” for employers when considering obesity drug coverage, including transparency around drug prices, flexibility in benefit design, and the ability to choose between independent administrators.
Through the program, employers can pay a discounted net price of $449 per month for a new multi-dose form of Zepbound at all doses, Hern said. He added that the agreement does not involve rebates and that the net price gives employers clearer visibility in determining 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 managers that help manage the costs and benefits of obesity treatment.
“Every employer is different. Everyone wants to design things around their unique needs and workforce,” Hern said.
Employers can choose from more than 15 administrators to design benefits that fit their budget and workers' needs. Some of the administrators may focus on managing obesity benefits to employees, taking care of basic functions such as enrollment, eligibility, claims, and more. Other managers may specialize in comprehensive obesity management and offer support to patients through telehealth, nutrition and lifestyle.
Lilly plans to expand the number of program managers 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 create some kind of platform where these companies could compete … on the value of their services to employers,” Hern said. All administrators offer the same drug at the same price, so employers will determine “who can best serve me in terms of administering this program as I define it.”
Those with government insurance could also see easier access to obesity drugs: Under landmark agreements Lilly and Novo signed with President Donald Trump, Medicare will cover those drugs for the first time later this year.
