Pick Your Path to Predictable GLP-1s: The Direct-to-Employer Model

A new pathway lets employers work directly with manufacturers to lock in transparent GLP-1 pricing, without sacrificing clinical care.

GLP-1s are one of the biggest advances in obesity medicine in decades, and, for most employers, one of the fastest-growing lines on the pharmacy budget.

According to Gallup, GLP-1 use for weight loss in the U.S. nearly quadrupled between 2024 and 2026, climbing from 3% to 11% of the adult population. Overall GLP-1 use, including for diabetes, rose from 6% to 15% over the same window.

Demand isn't slowing down. And with 75% of Americans able to qualify for coverage under typical eligibility criteria, rising prices aren't offsetting it either. Most employers are facing this decision whether they're ready or not.

Form Health is opening up a new pathway to GLP-1 access, one built to give employers predictable costs and employees uncompromised clinical care, so neither has to lose out to the other.

The two paths employers already know

Until recently, employees have gotten GLP-1s one of two ways:

• Direct-to-Consumer (cash pay): Employees pay out of pocket, insured or not. Manufacturer platforms like LillyDirect® and NovoCare® give patients a direct-to-consumer option outside the standard benefit.
• Through a PBM: For insured employees, the employer's Pharmacy Benefits Manager (PBM) prescribes off its formulary, with negotiated pricing, rebates, and usage-based discounts.

Most Form Health clients today prescribe through their existing PBM of record, and we have a proven track record of implementing that way. We can also help employers unlock the lowest available cash-pay rates through direct manufacturer partnerships, well below standard retail pricing.

But cash pay isn't a fit for everyone. Out-of-pocket costs don't count toward deductibles or plan accumulators, and they tend to climb as members titrate up.

A third path: Direct-to-Employer (DTE)

A Direct-to-Employer (DTE) pathway, enabled by Form Health, lets employers work directly with manufacturers to secure GLP-1s at a transparent, predictable price. It's built to deliver cost savings for the company and the employee at the same time.

What employers get with DTE

Employers who administer their obesity management medication (OMM) benefit through Form Health get:

• Manufacturer-direct pricing: completely transparent, predictable GLP-1 costs
• Full flexibility: employers decide how much the company pays vs. what employees contribute
• Guaranteed value: 100% of our fees are at risk, tied to required, on-label prescribing

Every prescription is severity-aware, FDA-aligned, and on-label, which is how employers using Form Health achieve market-leading clinical outcomes at both the individual and population level. Employers get full visibility into program performance and the insight to keep it moving in the right direction, backed by fees we put on the line.

Form Health's marketing team also builds a customized communication plan for every partner, so employees actually understand and use the benefit. Plans span offline and online channels, plus a variety of resources the team can share directly.

What makes DTE through Form Health different

Every qualifying member on the DTE pathway gets Form Health's full clinical model for obesity and cardiometabolic care, not just a prescription:

• Evidence-based physician-led virtual care with Care Teams that include advance practice providers, y  Registered Dietitians (RDs) and support staff.
• A comprehensive, individualized approach combining lifestyle support, behavioral health support, and FDA-approved medication, as clinically appropriate
• In-network medical claims billing
• Transition-of-care expertise to move GLP-1 patients into appropriate ongoing care
• Flexible models that adapt to your existing coverage

The result: employees get a personalized weight-loss journey through Form Health's virtual care platform, and employers get the confidence that OMMs are being prescribed responsibly, based on disease severity, with clinical oversight driving both outcomes and cost down.

Form Health Insight: Eli Lilly® and Novo Nordisk® have partnered with Form Health to bring their transparent, manufacturer-direct rates to the marketplace. Several existing Form Health clients are already transitioning to this model.

How DTE works with HR and benefits teams

If DTE is the chosen pathway, the Form Health contract gives the workforce access to manufacturer-direct pricing. Form Health’s pharmacy partner CenterWell Pharmacy handles fulfillment, with mail-order delivery for employees.

PBM adjudication, the process that evaluates, prices, and approves or denies each prescription, runs through SmithRx. Employers decide whether the member share is $0, reduced, or full cost.

What the experience looks like for employees

Every patient gets personalized, physician-led care, delivered entirely virtually, on a consistent cadence:

• One monthly medical visit
• One to two monthly Registered Dietitian visits
• Two to four optional weekly group classes
• 24/7 physician-staffed emergency line
• 24/7 access to resources in the Form Health app
• Secure in-app messaging with their Care Team
• A connected digital scale for at-home tracking

A better way to get GLP-1s to the patients who need them

Form Health has years of experience managing every path to GLP-1 access, including work with transition-of-care groups, to help patients reach Center of Excellence-level care.

Care is always physician-led, by ABOM-certified doctors and board-certified endocrinologists, for patients in all 50 states and Washington, D.C. Patients can chat in real time with a dedicated doctor, an advanced practitioner, and a Registered Dietitian.

A flexible partner, regardless of the starting point

Whatever the current GLP-1 offering looks like, Form Health can help find a path that fits their needs and employees'. The model flexes with employers:

• Use Form Health as required, as optional, or with required wraparound support, depending on their goals
• 100% of our fees are guaranteed against the outcomes you're trying to achieve as a business

Example: If employers already have a population on GLP-1s and want Form Health to take over support, we have direct experience transitioning those patients without disrupting their care.

To find out more by connecting with our team.

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