The weight-loss market is rapidly transforming, forcing employers and employees to navigate a more complex and often confusing landscape. Online weight-loss programs are rising in popularity, and new Federal Drug Administration (FDA) decisions around Glucagon-Like Peptide-1 (GLP-1) compounding are reshaping both employer benefits and employee health outcomes.
In this evolving environment, it is critical to understand the key implications to make informed decisions that align with your organization’s goals. You can optimize your benefits strategy and support your employees’ well-being by understanding GLP-1 compounding, navigating the impacts of the recent FDA policy change and effectively evaluating weight-loss platforms. Keep reading to dive deeper into each of these important considerations.
1. Understand GLP-1 Compounding
When the FDA placed Ozempic® and Wegovy® (semaglutide) on its drug shortage list in 2022, it allowed legal compound versions of the drugs to emerge. Compounders create semaglutide injections with the same active ingredient as the branded weight loss drugs, such as Ozempic and Wegovy, but they do not need to undergo the FDA's rigorous approval process. These compounded versions typically come with a significantly lower price tag. However, employees must carefully evaluate compounded products, as not all compounds are safe due to the lack of regulation.
In late February 2025, the FDA removed Ozempic and Wegovy from its shortage list, requiring compounding pharmacies to end dispensing of the medications by April 22 and compounding outsourcing facilities to end production by May 22.
If you’re an employer covering compounds of Ozempic and Wegovy, it’s a good time to connect with your pharmacy benefits manager to evaluate how this change will impact your benefits.
"Ending compounding of Ozempic and Wegovy may actually put more pressure on employers to provide coverage of weight loss medications,” notes Daniel Wilson, PharmD, BCPS, Vice President, Clinical Operations, True Rx Health Strategists. “The lower cost of compound drugs has made these medications more accessible to thousands of patients. For many, health insurance coverage will now be the only practical option for continuing the medication."
2. Navigate the Impacts of the Recent FDA Policy Change
When the FDA clarified policies for compounders late February in this drug availability statement, they acknowledged that patients and prescribers may still experience intermittent and limited localized supply disruptions as manufacturers and distributors move the products through the supply chain to local pharmacies.
In addition, a group of drug compounders are suing the FDA over its decision to declare the shortage resolved, arguing the move will deprive patients of vital treatment. As noted in BioPharma Dive, the suit, brought by the Outsourcing Facilities Association and North American Custom Laboratories, claims the decision was “arbitrary, capricious, and contrary to law” because the FDA didn’t notify compounders in advance, nor allow for public comment.
"The current lawsuits could result in compounding facilities being able to continue production while this case works its way through the courts,” notes Wilson. “However, employers should evaluate coverage decisions as if the current FDA ruling will hold and compounds will not be available, keeping the long-term picture in mind."
3. Effectively Evaluate Weight-Loss Platforms
As employers look to balance cost-effectiveness with positive health outcomes, many view weight-loss platforms or programs that complement pharmacy benefits as an ideal solution.
Regardless of if you cover weight loss or don’t cover weight loss in your plan, you have to develop a strategy as an employer,” says Christine Johnston, MBA, founder of Foundational Pharmacy Strategies, who also weighed in on compounded pharmacies in True Rx’s latest webinar addressing the 2025 Drug Pipeline.
However, with so many programs now available, it can be challenging to identify a program that will truly deliver results. To make an informed decision, consider asking these questions:
- What types of counseling and wellness education are provided to patients, and how comprehensive are these services? How are interactions conducted (e.g., telephone, live messaging, video call)?
- Are medication costs included in the program membership, or are there additional fees beyond the program cost?
- From which pharmacy do patients receive their medications, and what is the process for dispensing?
- What outcomes of the program are reported as a measure of success, and how are these outcomes measured and tracked over time?
While many online platforms advertise access to dietitians or claim to offer nutritional support, employees may never actually be able to interact directly with these professionals. Instead, they may only have access to pre-built content created by these experts, limiting the personalized and tailored support they need.
Human Resources (HR) benefits managers should not take weight-loss programs and coverage decisions lightly. As Christine expands in the webinar “Some employees are actually making decisions about whether they go to a particular employer or not based on if they cover this drug class.”
Further Explore the Cost of Obesity
True Rx offers two resources that explore the cost of obesity and benefit decisions for employers. Read the blog Are Weight-Loss Health Benefits a Winning Strategy for Employers and view the webinar, Hottest Health Strategies to Tackle Your Highest Costs: Managing Obesity.