The Future of Obesity Care Requires a New Benefit Model
GLP-1 and GIP medications are fundamentally changing how obesity is treated. These therapies do more than support weight loss. They reduce the risk of serious comorbidities such as diabetes, cardiovascular disease and hypertension. For employers, that translates to healthier populations and lower long-term healthcare costs.
Yet as demand surges, a stark reality has emerged. Traditional benefit models were not built for this level of utilization. Costs are rising rapidly, forcing employers to pull back coverage and leaving patients without viable options. Plan sponsors are now searching for solutions that can support access without sacrificing financial sustainability.
The Current Model Was Never Designed for This
Employers want to support healthier outcomes. Patients want access to therapies that work. But GLP-1 utilization within the traditional pharmacy benefit has proven financially unsustainable, leading many plan sponsors to restrict or eliminate coverage entirely.
Even as manufacturers lower cash prices, access through the traditional PBM model continues to shrink. This growing disconnect leaves patients without clear pathways to care while employers struggle to balance cost containment with benefit expectations.
Some PBMs have introduced weight management programs in response. However, many remain constrained by legacy incentive structures that prioritize utilization volume over long-term outcomes, transparency or patient experience.
Without a new approach, the opportunity to meaningfully improve population health through obesity care will be lost.
A Better Model is Emerging
Carve-out weight management programs are emerging as a more sustainable alternative. By separating obesity care into a dedicated, clinically managed benefit, employers can:
– Maintain control over program design and cost
– Ensure clinically appropriate access to GLP-1 medications
– Pair medication with digital therapeutics and patient engagement
– Manage costs through transparent, measurable program design
By removing obesity care from the traditional pharmacy benefit, employers gain flexibility while patient receive a more intentional, supported path to therapy.
What Sustainable Obesity Care Requires
Effective carve-out solutions require more than access to medication alone. They demand an ecosystem that connects technology, clinical judgment and human support. At HealthDyne, we believe the future of obesity care depends on:
– Technology that enables, not replaces, human connection
– Patient journeys designed to support sustainable, long-term results
– Clinical rigor that ensures the right patients receive the right therapy
– Data visibility that allows employers to measure impact
This is where modern pharmacy infrastructure becomes a strategic advantage. Powering real-time intake, benefit navigation, affordability pathways and ongoing patient engagement that help individuals start and succeed on therapy.
The Future of Obesity Care
Obesity is a complex, chronic condition. Treating it effectively requires benefit models that reflect that complexity rather than a one-size-fits-all approach. Carve-out weight management solutions offer a more sustainable path forward. For employers, they deliver cost control, transparency and accountability. For patients, they restore access, continuity and care.
As the market evolves, the future of obesity care will be shaped by organizations willing to rethink benefit design, invest in patient experience and move faster than traditional models allow.
At HealthDyne, we’re committed to building that future. Because better access leads to better health, and better health leads to lower costs for everyone.
