Alexis Sova, Pharm.D., MBA, on GLP-1 access when coverage ends | PBMI 2026

Employers that decide to stop covering GLP-1s for weight loss are increasingly pairing that decision with support for the members affected, according to Alexis Sova, Pharm.D., MBA, a clinical advisor at Employers Health. Sova spoke with Managed Healthcare Executive (MHE) at the 2026 Pharmacy Benefit Management Institute (PBMI) Annual National Conference in Orlando, where she was a panelist on a session about building a sustainable obesity and cardiometabolic benefit.

Sova said the approach varies from client to client, but a year or two ago, excluding coverage tended to be “more of a harsh cutoff” for employers and their workers. Now, with direct-to-consumer offerings available and some clients covering weight management programs, members who lose coverage have access to wraparound support, whether they are transitioning off the benefit or trying to find the most cost-effective way to continue therapy on their own. Those programs “do ultimately provide more of that lifestyle and diet management,” she said, which helps members manage their condition beyond medication alone.

Interest in direct access alternatives is growing, Sova told MHE. “We’ve had more and more questions from clients and consultants about those direct-to-consumer options, and even now the direct-to-employer opportunities that are available,” Sova said.

The program clients ask about most, she said, is Lilly Employer Connect. Eli Lilly launched the program in March 2026, pairing employers with more than 15 independent program administrators, including GoodRx, Teladoc Health and Mark Cuban Cost Plus Drug Company, and offering the Zepbound KwikPen at $449 per month across all doses. What employers and employees ultimately pay depends on dispensing fees and administrator costs negotiated separately. Under the model, Sova explained, an employer contracts directly with one of those vendors to obtain the manufacturer’s direct pricing.

For plan sponsors, a key advantage over members buying on their own through LillyDirect or NovoCare is visibility into claims flowing through the direct-to-employer channel. “That way, you don’t lose track of if those members are filling, and you can compare that to maybe even some of the data on the medical benefit side,” Sova said.