GLP-1 medications, first developed for type 2 diabetes, have become a major focus in prescription coverage and wellbeing since their approval for weight management in 2021.

According to Sequoia’s 2025 Wellbeing Trends Report, 26% of companies now cover GLP-1 medications, a figure that jumps to 40% among employers with more than 500 employees. Yet only 14% offer third-party wraparound programs to support behavioral change alongside medication, a gap that raises questions about outcomes and ROI.

At the 2025 Grove Conference, a panel of experts explored how employers are approaching GLP-1 coverage, from pharmacy strategy to clinical integration and behavioral support. The discussion, moderated by Shannon Arens, Sequoia’s director of wellbeing, featured:

  • Deborah Hanus, CEO & co-founder, Sparrow
  • Stan Scott, VP of care navigation & GLP-1 management, Rightway
  • Adele Feng, director of clinical operations, Found
  • Nelsie Nelson, pharmacy director, Sequoia

Keep reading for the key takeaways or watch a recording of the session below.

Employer Perspective

Sparrow’s approach to health and wellness starts with employee feedback and rigorous data analysis. Hanus shared how her partnership with the head of people ensures every decision is grounded in both the business case and employee needs. Engagement surveys and annual benefits surveys help Sparrow understand what’s working, and what’s not, while driving for participation rates above 95% through leadership support and creative incentives.

“It really goes back to consistently talking to employees and getting good data,” Hanus said. “If you have access to that, it’s usually obvious whether the plan is meeting their needs.”

By setting clear expectations and communicating budget constraints, Sparrow aims to support as many employees as possible within available resources, without losing sight of wellbeing goals.

Pharmacy Spend and Coverage Strategies

Pharmacy benefits account for about 30% of total healthcare spend, and GLP-1s are a growing driver.

To manage costs, Nelson recommends understanding the levers available to you. Fully insured employers should work with carriers on formulary and utilization management options like prior authorization, step therapy, quantity limits, and BMI thresholds. Many carriers also offer weight management programs that pair medication with coaching and nutrition support.

Self-funded employers have more flexibility, including PBM partnerships and third-party programs, but that comes with greater responsibility, such as added costs and administrative work. “As you consider your options, weigh cost impact and employee experience,” Nelson said.

The Role of Pharmacy Benefit Managers

Scott emphasized that adherence is a major challenge. “One of the big challenges is that people stop and start the use of these drugs,” he said, citing a study showing only 14% of GLP-1 users remain on therapy after three years.

Pharmacy benefit managers (PBMs) can help by setting stricter criteria, refill limits, and dollar caps, while also supporting members with pharmacist-led guidance. “As a PBM, we have a responsibility to make sure the right people are getting these drugs and that they are adhering,” Scott said.

Wraparound Programs

Feng stressed that medication alone isn’t enough.

“It really starts with clinical philosophy,” she said. “Combining medication and lifestyle change helps people lose weight and keep it off.”

Wraparound programs add coaching, nutrition support, and digital tools to improve outcomes and reduce pharmacy spend over time.

“Successful lifestyle change means someone can start to wean off medication usage,” Feng explained. That can lead to lower doses and fewer prescriptions, creating a domino effect of savings across weight-related conditions.

Measuring ROI: Employer Perspective

ROI falls into two buckets: hard financial value and soft workforce impact, Nelson said.

For hard ROI, there’s strong data on GLP-1s for diabetes, but it’s still early to see definitive returns for weight management.

Soft ROI is about workforce impact and how benefits influence attraction, retention, and engagement.

“We all want to see a healthy, productive workforce, and loyalty over time,” Nelson said. “Is this part of the strategy that could help with that?”

Measuring ROI: PBM Perspective

Scott noted that employers need visibility into whether their investment is paying off.

“We’re trying to work with our employer clients to give them better insight, and I feel like there’s lots of data blind spots. We see the news articles and we see the hype that these drugs work, and they do, but they don’t work for everyone, and so how do we help employers really kind of sift through all that and understand, am I really getting the bang for my buck?”

He explained that Rightway looks at spend on a quarterly basis and tries to connect it to outcomes.

Measuring ROI: Wraparound Program Perspective

Feng explained that Found approaches ROI from both hard and soft savings.

“Found is both a core program and a wraparound program,” she said. “When we look at hard dollar savings, the first thing we measure is reduction in branded GLP-1 expenses.”

Branded GLP-1s are costly, so Found leverages a wide medication formulary that includes non-GLP-1 medications and compounded GLP-1s, which are more affordable.

She added that pharmacy benefit design also plays a role. “GLP-1s don’t necessarily have to be the first line for everyone,” she said. Flexible program design and step therapy can help reduce spend on expensive branded drugs.

Beyond medication costs, Found evaluates reductions in medical and pharmacy spend for weight-related conditions such as diabetes, sleep apnea, musculoskeletal issues, and even mental health. On the soft savings side, Feng pointed to decreases in absenteeism, fewer workers’ compensation claims, and fewer short-term disability claims. “All of that rolls up into how we look at ROI,” she said.

Final Takeaways

Employers are weighing affordability against outcomes, exploring pharmacy levers, and considering wraparound programs to make GLP-1 coverage sustainable. While hard ROI data for weight management is still developing, the potential for improved health and workforce engagement is clear. Start by reviewing your data, engaging your carrier or PBM, and educating employees on available resources. Aim for more than offering coverage. Build a long-term strategy that supports your people and your business.

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