Novo Nordisk and Eli Lilly bypass PBMs with direct weight-loss drug sales to employers
Novo Nordisk and Eli Lilly bypass PBMs with direct weight-loss drug sales to employers
Novo Nordisk and Eli Lilly bypass PBMs with direct weight-loss drug sales to employers
Novo Nordisk and Eli Lilly are launching a new way for U.S. employers to buy weight-loss drugs directly. Starting January 1, companies can purchase Wegovy and Zepbound without involving traditional pharmacy benefit managers (PBMs). The move aims to cut costs and simplify access for employees whose health insurance currently excludes these medications.
The initiative comes as a second attempt by both drugmakers to expand direct-to-consumer sales of their GLP-1 treatments. This time, they are partnering with Waltz Health, a digital health firm specialising in affordable medication programmes for employers.
The new model will offer fixed upfront pricing, removing the rebates and fees that usually go to PBMs. Employers will pay a set price, which the companies claim will be the lowest-cost option for workers. The approach also seeks to create an open marketplace where drugs compete on clinical value and affordability rather than negotiated discounts.
Four companies have already agreed to adopt the system. The shift primarily targets employers whose health insurance does not cover weight-loss medications—currently only about 43% of large firms with over 5,000 employees include such drugs in their benefits.
The change directly challenges major PBMs like CVS Caremark, Express Scripts (Cigna), and OptumRx (UnitedHealth). These intermediaries traditionally control drug pricing and rebates for employer-sponsored plans, which cover roughly 165 million U.S. workers. By selling through telemedicine platforms, Novo Nordisk and Eli Lilly bypass PBMs, reducing their influence over high-demand medications like Wegovy and Zepbound.
Waltz Health will manage the digital distribution, ensuring employees can access the drugs at predictable costs. The model mirrors the companies' earlier direct-to-consumer efforts but now focuses on bulk employer purchases instead of individual sales.
The new system starts on January 1, offering employers a way to provide weight-loss drugs without PBM markups. It could lower costs for workers while reshaping how high-demand medications are distributed. The impact on traditional PBMs remains to be seen as more companies consider switching to the direct model.