First Stop Health, a virtual care platform, announced the expansion of its Healthy Weight program in response to demand for GLP-1 and associated increases in health plan costs.
This program integrates weight management directly into the primary care model, including GLP-1 prescribing when appropriate. New to the program is a cash payment access option for employers who do not currently cover GLP-1 prescriptions and a managed compensation program for employers who do.
“The goal is not just to lose weight; it is to improve metabolic health and reduce long-term health risks,” Cole Barfield, M.D., chief medical officer at First Stop Health, said in an email to Fierce Healthcare.
Barfield said the virtual care platform will assist “employers on either side with coverage decisions” by “combining clinically appropriate prescribing with primary care, nutritionists, health coaches and diabetes educators who support sustainable behavior change.”
“Medication can be transformative, but it is most effective when it is part of a true caring relationship that focuses on the whole person,” Barfield said.
First Stop Health will begin piloting the program in 2025, with a broader launch planned for 2026, the company said. In the first year of data analysis, one employer saw 100% of participants lose weight over 12 months, with an average weight loss of 19% per patient. Additionally, executives said that no participants had class 2 or class 3 obesity after the period, and 25% achieved a healthy body mass index (BMI).
In terms of savings, First Stop Health estimates annual savings of $1,500 to $2,800 per person, and up to $9,000 for those starting with Class 3 obesity.
“For many employers, the GLP-1 landscape is nothing short of confusing, forcing them to sort through numerous point solution options without a clear path to managing usage or ensuring outcomes,” First Stop Health CEO Tayla Gunlock said in a statement. “We built this program because we believe that to deliver outcomes that employers and employees can trust, medication needs to exist within a true care relationship, not a standalone app.”
Despite the GLP-1 boom, a recent report from Pharmaceutical Strategies Group (PSG) found that 49% of payers who do not cover obesity drugs say they intend not to do so at any cost.
When asked the top reason for exclusion, 45% of respondents, ranging from employer benefits directors to unions, said premiums are too high for all union members who are prescribed the drug. Other factors include considering the drug as a lifestyle medicine (24%), ongoing costs (18%), and poor ROI due to high discontinuation rates (5%).
