The Growing GLP-1 Ecosystem

In 2024, the dramatic increase in GLP-1 utilization has driven a corresponding explosion of new weight-loss solutions and vendors incorporating management of this drug class into their offerings.

What Employers Should Know

The expanded adoption of GLP-1 medications for diabetes and obesity treatment has driven a 70% increase in utilization between 2021 and 2023¹, with further growth anticipated in 2025. The growing utilization and the high cost of medications have made GLP-1s a significant contributor to rising employer healthcare costs. It is currently estimated that GLP-1s account for approximately 10% of pharmacy costs, with employers spending an additional $5 to $15 per member per month on these medications.²

What Employers Can Do

Research indicates that GLP-1s are most effective for specific populations and have a more lasting clinical impact when paired with lifestyle change programs. Employers can leverage four main strategies to manage the costs of and access to GLP-1s:

1. Utilization management using FDA or less restrictive guidelines
2. Offering or requiring enrollment in a program that supports holistic health, including physical activity, healthy eating and emotional health, to be prescribed GLP-1s
3. Restricting prescribers to particular physicians, groups or vendors who can provide clinical oversight, supervision and accountability for the lifestyle change needed for a lasting benefit
4. Putting a lifetime limit/cap on GLP-1 benefits

Improvements in Cancer Detection and Treatment through Precision Medicine

Scientific advancements are providing new opportunities in early cancer detection and treatment, which can, in turn, reduce costs and improve outcomes.

What Employers Should Know

Since these tests can take many years to incorporate into traditional medical practice, vendors are increasingly approaching employers directly. Although genetic, genomic and multi-cancer early detection (MCED) testing are promising breakthroughs, such tests’ increased availability and utilization should be carefully considered and planned. These screenings and tests can be costly and may increase demand for targeted, high-cost therapies. The testing also brings a myriad of issues employers must consider prior to offering – such as FDA approvals, policy implications and appropriate follow-up care.

What Employers Can Do

Employers should look to balance the potential value of improving cancer prevention, detection and treatment with evidence-based benefit design that reduces unnecessary spending. Cancer testing should be added to the benefit package in a manner that ensures connection to other benefits, a seamless patient experience and effective utilization by the members who will need and benefit from it most. Employers need to understand the science, the data, privacy, compliance and how best to implement and support these types of testing programs/coverages, including providing education on the results and navigation to the next steps.

Menopause Stigma Dissipates

Triggered by a decline in reproductive hormones, people experiencing menopause often have symptoms that include hot flashes, headaches, sleep disturbances and mood swings, all of which can negatively impact health, productivity and performance.

What Employers Should Know

Approximately 30% of the U.S. labor force is made up of women aged 45 to 55, many of whom are experiencing menopause. Due to menopause-related symptoms, nearly 20% have considered leaving their jobs.³ The loss of experienced employees leads to higher recruitment and training costs and a decline in organizational knowledge and leadership.

What Employers Can Do

Employers can attract and retain top female talent by prioritizing women’s health at all stages of life. Partnering with a menopausefocused or comprehensive women’s health provider can offer access to specialists who understand menopause and its impacts. Employers should foster an open dialogue about menopause and provide reliable information and educational resources. Additionally, policies that promote flexible work arrangements and modifications in the workplace’s physical environment, such as proper ventilation and fans, can help women manage symptoms and navigate this life stage effectively.

Menopause | The Next Frontier in Employee Benefits

A Greater Recognition of Food as Medicine (FAM)

Although diet has long been recognized as connected to metabolic health, the ability of proper and tailored nutrition to prevent and improve health conditions gained increased recognition in 2024.

What Employers Should Know

Food as medicine shifts the traditional healthcare paradigm from treating disease exclusively with medication to incorporating nutrition and dietary interventions. This holistic approach to health and well-being is both effective and cost-effective. Studies on medically tailored meals (MTM) – one example of a FAM program – have been shown to lead to a 37-52% lower risk of hospitalization and 16% to 31% reduction in monthly healthcare expenditures. Another study estimated private payors’ cost-savings would net $3 billion in one year if all eligible individuals (n=6.3 million) received MTMs.⁴

What Employers Can Do

Employers should anticipate new programs, policies and benefit designs to support nutrition and dietary interventions, including prescriptions for fresh produce, medically tailored groceries and/or meals and programs educating employees to leverage food more strategically to nourish and heal the body. As employers evaluate these programs and consider food as medicine opportunities, they should also assess and account for socioeconomic factors that may impact the quality and quantity of food to which employees have access.

Food as Medicine | Employers, It’s Time to EAT

Solution Fatigue Drives Vendors to Expand

For the employer, the administrative burden of onboarding, integrating and communicating each solution has created a sense of “solution fatigue.” For the employee, it has led to fragmented care, lack of awareness and ultimately, limited engagement.

What Employers Should Know

Employers’ desire to reevaluate and possibly scale back vendor relationships has led vendors to expand services and position themselves as a one-stop shop for multiple healthcare issues. Over the last year, metabolic vendors have added musculoskeletal services, employee assistance program (EAP) vendors add metabolic health services and many other unique combinations of services. While vendors aim to simplify the administrative burden for employers and deliver a more integrated experience to employees, expanding services could dilute these vendors’ value and reduce the engagement and effectiveness of each service.

What Employers Can Do

Employers should approach each vendor relationship with clear performance requirements for each program/service. These requirements should emphasize a comprehensive communication plan that details how often and to whom the solution will be communicated to drive engagement and the outcomes that will be achieved. If working with a single vendor delivering multiple services, an employer should have requirements in place for each service and ensure outcomes are not compromised. If working with multiple vendors, an employer should have an overarching strategy that both monitors outcomes and evaluates them for duplicative services.

¹ Prime Therapeutics. The evolution of GLP-1s. September 1, 2024
² Prime Therapeutics. The evolution of GLP-1s. September 1, 2024
³ What Is Menopause? | National Institute on Aging
⁴ Tufts True Cost of FIM Case Study – Oct 2023.pdf

Employee Benefits Team