GLP-1 drug coverage is a workforce health strategy, not a pharmacy problem

What good GLP-1 plan design actually looks like

Collier is direct about what separates effective GLP-1 benefit design from open-ended coverage that generates cost without proportionate return. The starting point is evidence-based eligibility: body mass index combined with type 2 diabetes, cardiovascular risk, or kidney disease. From there, two levers determine whether coverage delivers value — structured support programs and thoughtful cost-sharing.

On support, adherence is the central challenge. “There are reasons — side effects, et cetera — where people choose not to continue,” Collier said. “And then you are mitigating, you’re losing out on the value that you would get further down the road after you’ve taken on the expense.” Coaching, behavior change reinforcement, and care navigation are not optional add-ons — they are the mechanism through which GLP-1 coverage generates long-term return.

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On cost-sharing, the financial reality facing most American workers makes high out-of-pocket costs a direct driver of non-adherence. “Most Americans don’t have $800, $1,000 in disposable cash,” Collier said. “They want to have the benefits. It’s not for lack of want, but then you get into a decision between my finances and my health choices.”

The structural tension here is significant. HR leaders navigating an environment of rising medical trend — Collier described it as having “made a material step up” in recent years — are under pressure to pass more costs to employees. But benefit plans built around long-term behavior change cannot function if cost-sharing levels price employees out of adherence.