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Nonetheless, employers are responding with cost-control strategies that include: Prior authorization and clinical criteria (BMI or comorbidities) to confirm medical necessity and prevent off-label use Direct-to-consumer partnerships and transparent pharmacy benefit manager (PBM) contracts for better pricing and rebate pass-through Utilization monitoring and adherence programs to track outcomes and avoid waste from early discontinuation Step therapy to ensure appropriate use of lower-cost alternatives before GLP-1 initiation Alternative coverage models such as value-based arrangements or outcomes-based contracts tied to weight-loss results Employee education and lifestyle support to pair medication with nutrition and behavioral programs, improving effectiveness and reducing long-term spend Compliance and regulatory considerations In offering GLP1 health plan coverage, employers must navigate a complex regulatory landscape to ensure ethical, effective, implementation thats in line with federal, state, and legal requirements including: FDA approval and offlabel use Plans should align coverage with FDA-approved indications (see chart) and require prior authorization to ensure that any off-label use is supported by medical necessity

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