Sova, a clinical advisor for Employers Health, expects more employers to exclude GLP-1s for obesity but urges a look at coverage for specific cardiometabolic conditions.
Feature|Videos|September 23, 2026
Alexis Sova, Pharm.D., MBA, on employers pulling back on GLP-1 coverage | PBMI 2026
Author(s)Peter Wehrwein, Managing Editor
Approximately two-thirds of Employers Health clients now exclude GLP-1s for obesity, up from a roughly even split at launch as cost drives coverage decisions.
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Employers are increasingly dropping coverage of GLP-1 drugs for obesity, with about 65% of clients at one pharmacy benefits purchasing group excluding the medications as of the first half of 2026. Alexis Sova, Pharm.D., MBA, a clinical advisor at Employers Health, described the trend in an interview with Managed Healthcare Executive after speaking on a GLP-1 panel at the 2026 Pharmacy Benefit Management Institute (PBMI) Annual National Conference in Orlando, Florida, earlier this month,
Employers Health is a group purchasing organization for pharmacy benefits that works with self-insured employer groups. It has about 500 clients across all 50 states and manages $6 billion in pharmacy spend.
When GLP-1s for obesity entered the market in 2022 and 2023, Employers Health clients were split roughly 50-50 on coverage, Sova said. Each year since, more have chosen to exclude the drugs. The roughly 35% that still cover them do so in a variety of ways, she said, with some covering the drugs at 100% member cost share and others adopting unique solutions or mixed coverage decisions.
The driver of the coverage, according to Sova, is cost: the size of the population eligible for GLP-1s combined with the drugs' current price point. The pullback comes despite broad recognition of the medications' clinical value. “I don’t think anybody wants to close off coverage,” Sova said. She pointed to the drugs' efficacy in overall cardiometabolic health beyond obesity, as well as in supplemental indications such as the liver condition MASH, sleep apnea and the reduction of cardiovascular events.
Sova was on the panel at PBMI session titled, “GLP-1s at the Tipping Point: Building a Sustainable Obesity and Cardiometabolic Benefit,” that included Kathryn Eshelman, M.D., M.P.H., vice president of medical informatics at Inovalon; Jo
nathan Ogurchak, Pharm.D., CSP, CPHIMS, CEO of STACK/Zeal Specialty; and Richard Frank, M.D., M.H.S.A., chief medical officer at Vida Health.
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