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GLP-1 Coverage Strategies for Plan Sponsors
Verrill Dana LLP
Mar. 2, 2026 "There is growing buzz around a new approach to GLP-1 coverage: removing GLP-1 coverage from the traditional [PBM] reimbursement model and instead reimbursing employees for GLP-1s through a direct-to-consumer or 'carve-out' model tied to a utilization management program.... The concept works because GLP-1s are one of the few prescription drug categories with a robust direct-to-consumer market. It is unclear, however, whether increased contractual and operational costs will offset the savings from lower direct-to-consumer prices." MORE >> |
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