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Combining behavioral support with GLP-1s can enhance outcomes

Pairing GLP-1 medication with behavioral health support and long-term care can help members stay healthier longer and manage cost for payers and employers.
Reimbursement
By | November 5, 2025 | 10:00 AM
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Photo: Tatsiana Volkava/Getty Images

GLP-1 medications (e.g., semaglutide and tirzepatide), originally developed for type 2 diabetes, are now transforming obesity care. These drugs are now delivering benefits such as significant weight loss and improved cardiovascular outcomes, and patients may experience improvements in other conditions such as sleep apnea1 and Alzheimer’s disease.2

As a result, roughly 40% of large employers now cover GLP-1s for obesity.3 The cost curve, however, is steep. Annual per-member costs can exceed $16,000 before rebates.4 In addition, GLP-1s are not a cure-all. They don’t teach health habits, address stress or tackle all the root causes that can contribute to obesity. As a result, most GLP-1 users stop treatment within 12 months 5, often without a clear off ramp. This can lead to weight regain, lost progress and diminished ROI.6

As employers and payers balance tighter budgets and increasingly complex member needs, weight management is now both a clinical imperative and a financial one. A proactive plan that combines behavioral support, clinical guardrails and long-term care planning is essential. Those who prioritize whole-person care, deprescription planning, personalized pathways and equitable access will be best positioned to control spending and support meaningful member outcomes.

To learn more about how payers and employers can better control spending and support meaningful member outcomes through whole-person care, read the full article here.

References

  1. Malhotra, A., Grunstein, R.R., Fietze, I., et al.; 2024. Tirzepatide for the treatment of obstructive sleep apnea and obesity. N Engl J Med 391(13). https://www.nejm.org/doi/full/10.1056/NEJMoa2404881.
  2. Chen, E. October 24, 2024. Ozempic linked to lower risk of Alzheimer’s diagnosis in observational study. STAT. https://www.statnews.com/2024/10/24/ozempic-novo-nordisk-alzheimers-study/.  
  3. ZS Associates. 2024. 3 health plan strategies for balancing cost and access with GLP-1s. https://www.zs.com/content/dam/pdfs/3-health-plan-strategies-for-balancing-cost-and-access-with-GLP-1s.pdf.
  4. ZS Associates. 2024. 3 health plan strategies.
  5. Arillotta, D., Floresta, G., Guirguis, A., et al. 2023. GLP-1 receptor agonists and related mental health issues: Insights from a range of social media platforms using a mixed-methods approach. Brain Sci 13(11):1503. https://pmc.ncbi.nlm.nih.gov/articles/PMC10669484/.
  6. ZS Associates. 2024. 3 health plan strategies.
Topic:
Accounting & Financial Management,
Reimbursement,
Revenue Cycle Management