Understanding GLP-1 Medications and Increasing Utilization
GLP-1s, or glucagon-like peptide-1 agonists, are a class of medications seeing increasing effectiveness in managing Type 2 diabetes and obesity, with the potential to impact other medical conditions as well.
As a result, as interest and utilization of these expensive drugs have increased, so has the fiscal burden on employers providing their members’ pharmacy benefits.
To better understand how GLP-1 medications are impacting the pharmacy and healthcare space, Truveris has created resources to support employers and benefits professionals in building out comprehensive strategies to manage GLP-1 costs:
- GLP-1 Clinical Considerations (April 2026)
- eBook: Strategies for GLP-1 Management in Pharmacy Benefits
- How Pharmacy Plans Are Managing GLP-1 Coverage
- Case Study: Identifying Incorrectly Billed GLP-1 Claims
- Navigating Emerging GLP-1 Carve-Out Models
- FDA Approval of Oral GLP-1s – What Employers Need to Know
Resources for Managing GLP-1 Coverage and Spend
1. GLP-1 Clinical Considerations (April 2026)
In this on-demand webinar, Truveris Clinical Director Aya Desouki, PharmD, reviews the latest clinical developments influencing GLP-1 coverage and pricing in 2026. She explores emerging therapies (including oral GLP-1s), utilization management trends, and key strategic considerations employers should weigh as the GLP-1 landscape continues to evolve.
Key takeaways include:
- Clinical distinctions across current and emerging GLP-1 therapies
- Utilization trends, safety considerations, and cost drivers for employers
- The impact of PBM management strategies and new access models
- What to expect from the 2026 to 2027 GLP-1 pipeline
2. eBook: Strategies for GLP-1 Management in Pharmacy Benefits
In this comprehensive eBook, Truveris experts offer an educational look at GLP-1s and their growing pipeline as pharmaceutical manufacturers invest heavily into R&D to increase indications and fill the demand for these drugs.
This resource also shares step-by-step considerations employers need to keep in mind when planning for GLP-1 coverage, including examples of how public entities and employers are already structuring or restructuring their benefits to account for these medications.
Finally, our experts offer several metrics that employers should monitor on an ongoing basis to stay apprised of their GLP-1 utilization and spend:
- Gross/Net Cost to the Plan
- Number of Utilizers (including new utilizers over time)
- Number of claims (including adherence trends and refill patterns)
3. How Pharmacy Plans Are Managing GLP-1 Coverage
In this blog, Truveris experts break down 4 timely methods that employers are using to mitigate the high cost of GLP-1s while increasing appropriate access to members who need it most.
The four strategies include:
- Utilization Management (UM) with Prior Authorization
- GLP-1 Carve-Out Programs
- Ongoing Claims Oversight
- GLP-1 Claims Audits
By initiating a proactive and thoughtful approach to GLP-1 coverage, employers can adapt to increasing interest and use of these medications while ensuring long-term financial stability for the pharmacy plan.
4. Identifying Incorrectly Billed GLP-1 Claims Case Study
In this case study, we share how a group of Truveris clients discovered over $250,000 in unintended GLP-1 expenditures mid-contract due to PBM implementation errors.
While the groups had initially asked the PBM to exclude coverage for GLP-1s, the PBM was inadvertently allowing claims to come through, rapidly incurring unexpected costs for the groups.
5. Navigating Emerging GLP-1 Carve-Out Models
In this blog, Truveris experts break down how carve-in and carve-out GLP-1 models work, including the trade-offs related to pricing, utilization management, visibility, and clinical oversight. The article also examines two emerging carve-out approaches, lifestyle management programs and manufacturer-affiliated programs, and outlines the operational and financial implications of each.
Key takeaways include:
- Why GLP-1 carve-out models are gaining traction
- Shifting cost-control, oversight, and risk
- What employers should consider before moving GLP-1s outside the PBM
6. FDA Approval of Oral GLP-1s – What Employers Need to Know
This blog reviews the FDA approval of oral Wegovy and Foundayo, highlighting their impact on the GLP-1 market. This article compares oral and injectable therapies and summarizes the coverage, cost, and utilization considerations employers should evaluate as access and competition increase.
Key takeaways include:
- Why oral GLP-1s could significantly increase utilization
- How expanded indications may affect coverage decisions
- What employers should anticipate around cost and utilization management
Questions about GLP-1 drug coverage and pharmacy benefits strategies? Contact Truveris here.
Truveris is a leading digital health company focused on delivering truth and clarity in pharmacy. Truveris’ proprietary technology, coupled with deep pharmacy expertise, helps to build a more efficient market that maximizes choice, accessibility, and prescription drug affordability. Our solutions provide the insight and knowledge to help people lead healthier and more productive lives.
