Alexis Sova, Pharm.D., MBA, on where GLP-1 coverage goes next | PBMI 2026

More employers are likely to drop coverage of GLP-1 drugs for obesity in the months ahead, according to Alexis Sova, Pharm.D., MBA, a clinical advisor at Employers Health. But rather than treating the class as all-or-nothing, she said, plan sponsors should take a closer look at the drugs' other indications.

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.

As of the first half of 2026, about 65% of Employers Health clients exclude GLP-1s for obesity, up from a roughly even split when the drugs launched for the indication in 2022 and 2023, Sova said earlier in the interview. She expects the share of employers backing out of coverage to keep rising, even before the end of the year. “I’ve seen more and more clients inquire about excluding the GLP-1 class of medications for obesity,” she said.

What Sova said she would like to see instead is clients seriously evaluating the drugs' supplemental indications, even if they don't open up coverage for obesity as a whole. She pointed to the pipeline, including retatrutide, which which may be launched in late 2027 or early 2028 with multiple expanded indications. “I think clients really need to look at these medications no longer as just obesity medications but overall cardiometabolic medications,” Sova told MHE.

Sova spoke to MHE the 2026 Pharmacy Benefit Management Institute (PBMI) Annual Conference conference on the panel “GLP-1s at the Tipping Point: Building a Sustainable Obesity and Cardiometabolic Benefit,” alongside Kathryn Eshelman, M.D., MPH, vice president of medical informatics at Inovalon; Jonathan Ogurchak, Pharm.D., CSP, CPHIMS, CEO of STACK/Zeal Specialty; and Richard Frank, M.D., MHSA, chief medical officer at Vida Health.