Eli Lilly & Co. and Novo Nordisk A/S plan to start selling their popular obesity shots to employers through a new approach that would bypass traditional drug sales channels in an effort to expand access to the costly weight-loss medicines.
The drugmakers will offer Zepbound and Wegovy to companies starting Jan. 1 through Waltz Health, a firm that helps employers purchase cheaper medications. The shots will be available to employers at upfront, fixed prices, avoiding the rebates and fees that accompany traditional sales through middlemen who manage pharmacy benefits for many companies.
Lilly and Novo are already selling the drugs to patients through online “direct” services at big discounts to their list prices. While details are still scarce about how much workers will have to pay under the new model, with each employer determining how much the out-of-pocket payment will be for patients, a number of companies have already expressed interest, Waltz Chief Executive Officer Mark Thierer said in an interview.
Thierer declined to share what prices the company has negotiated with the drugmakers, but he said they were competitive. “This will be the absolute cheapest way” for a person on an employer benefit plan to get the drugs, he said.
The new offering comes amid broader upheaval in the drug market. President Donald Trump is cajoling pharmaceutical companies — including Lilly and Novo — into lowering prices in some government programs and pushing them to offer medications directly to patients at steep discounts to traditional prices. His administration also told PBMs to end drug rebates. The largest PBM, owned by Cigna Group, said it would take steps to do that, a move that alarmed Wall Street.
Many Americans don’t have insurance coverage for obesity treatments, and Lilly and Novo have been competing with lower-cost versions of the shots made by compounding pharmacies. They are also competing with each other. As a result, they have dropped their cash prices for those buying their drugs directly. Novo is selling Wegovy for a monthly cost of $199 for introductory doses and $349 after the first two months. That matches Lilly’s price for a low dose of Zepbound and is below the price of higher doses.
Novo declined to comment on the price it would make available through Waltz, but a spokesperson said “transparent initiatives like these enable more employers to opt in to coverage” for the brand-name medications.
“Lilly is building a new employer-focused model designed to expand access while giving plan sponsors more choice and flexibility,” Ilya Yuffa, president of Lilly USA, said in a statement. “Obesity care is the next frontier in employer health benefits.”
Employers who sponsor health plans for about 165 million Americans typically rely on pharmacy benefits managers to negotiate prices. Those PBMs have come under fire for their opaque processes, and for sometimes keeping a portion of drugmakers’ rebates and other fees.
Thierer said Waltz’s price doesn’t rely on rebates — the payments drugmakers make to PBMs and employers after a prescription is filled to reduce the cost — or various other fees pharmaceutical companies pay to intermediaries. Waltz won’t favor one drug over another, as some PBMs have. It will get a flat fee each time a prescription is filled by what Thierer describes as a “curated” pharmacy network.
“This is meant to be an open-source marketplace where drugs compete on their clinical merits” and price, Thierer said. Drug companies want “a level playing field,” he added.
The offering is aimed at employers that don’t cover obesity drugs right now. About 43% of companies with more than 5,000 workers cover weight-loss drugs, according to a recent survey from KFF. Thierer said four employer clients are signed up to launch the offering in January. Waltz is targeting a goal of making it available to 100,000 people by the end of the first quarter.
The arrangements will only apply to the companies’ weight-loss drugs, not to similar medications intended for diabetes. Waltz will handle screening patients to see if they’re eligible for the drugs, sending prescriptions to pharmacies and supporting patients taking the drugs.
Waltz was recently purchased by a larger firm, Eversana, that works with drug companies to commercialize and distribute their medications. Thierer, a former PBM executive, has said he aims to build an alternative to the “oligopoly” of PBMs and force the industry to change.
Separately, Eversana gets fees from drug companies for operating direct-to-consumer programs and other services.
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