GLP-1s are here to stay, but the payment model can’t stay broken.
Obesity care is finally getting the attention it deserves. With GLP-1 medications driving towards improved clinical outcomes, plan sponsors face a new challenge: how to offer access in a way that’s both clinically responsible and financially sustainable.
Unfortunately, current payment models weren’t built for this moment.
Formularies shift, costs spike, and members get caught in the middle – either boxed out or left without guidance. GLP-1 medications can exceed $1000 a month, and while affordability programs provide some relief, broad access remains limited and uneven.
It’s time for something better.
The limitations of the current coverage landscape
GLP-1 medications (like Wegovy, Zepbound, and Ozempic) are effective tools when used responsibly and paired with behavior change support, but the path to accessing them is uneven and often opaque. Members often deal with:
- Limited and inconsistent formulary coverage
- Strict prior authorization protocols
- High out-of-pocket costs
- A lack of clinical oversight
These friction points don’t just frustrate members; they lead to poor adherence, inequitable access, and delays or denial of treatment, leaving members feeling confused and unsupported, which can undermine outcomes, and increase long-term spend.
Access is no longer binary; it’s strategic
We need to move beyond “covered or not covered.” This outdated framing doesn’t match the real needs of members or the financial realities facing employers. Instead, we need to ask: What flexible, forward-looking care pathways can we offer that will allow more people to receive the right care, at the right time, in the right way?
At Vida, we’ve designed our care model to deliver just that.
We believe that there are multiple answers, but they should all come with clinical support baked in.
How Vida is redefining access
Vida takes a formulary-flexible, member-first approach to GLP-1 stewardship.. That means we adapt to each client’s unique coverage strategy, whether they offer full coverage, limited coverage, or none at all.
GLP-1s are not a standalone solution nor a checkbox. We’ve built a multi-pathway approach to medication access that allows us to adapt to the needs (and formulary structures) of our clients.
Here’s how we’re doing it:
Formulary-aligned protocols
We work within our clients’ existing plan design and benefits structure, aligning our clinical pathways to coverage decisions. Our clinicians follow strict, evidence-based criteria for prescribing and deprescribing to ensure appropriate and responsible use.
A new pathway with RxSaveCard
We recently partnered with RxSaveCard to expand affordable access for members who don’t have GLP-1 coverage through their health plan or are facing high out-of-pocket costs. This partnership is designed to help the member explore safe, lower-cost options for accessing their medications, with our licensed providers guiding the process every step of the way.
This isn’t a workaround. It’s an expansion of access, putting affordability and safety on the same team.
Whole person care around every prescription
Medication alone won’t drive long-term success. That’s why our GLP-1 pathway gives every member personalized support from physicians, registered dietitians, health coaches, and therapists. This model targets the key drivers of obesity: nutrition, activity, stress, sleep, and mental health. We help empower members to create meaningful and sustained behavior change to ensure the long term success of the outcomes achieved through the help of GLP-1s.
Prescribing with accountability
Our clinical teams don’t just prescribe. They monitor labs, adjust medication dosages, track care plan adherence, and more.
It’s not just about access — it’s about responsible use that builds trust, and protects long-term health and spending.
Why this matters for plan sponsors
Employers and health plans are under pressure to act — but also to act wisely. With the rising demand for obesity care, coverage decisions made today will shape downstream costs, member satisfaction, and clinical outcomes for years to come.
Vida helps to take that pressure off. Our approach is built to:
- Align with your formulary and cost strategy
- Protect long-term affordability and adherence
- Expand access without overutilization
- Support both medicated and non-medicated members
- Provide medication without sticker shock
The result: lower risk, better outcomes, and a more sustainable path forward.
Looking ahead: a smarter GLP-1 strategy starts now
The market is moving fast. But moving fast without flexibility and clinical depth isn’t a strategy, it’s a risk.
At Vida, we’re helping clients take a smarter approach. One that blends affordability, access, clinical excellence, and human support.
Because the future of obesity care isn’t just about who gets a prescription, it’s about who gets better and how many ways we can help them get there.
