GLP-1 Benefits Are Growing Fast: The Follow-Up Problem Nobody Talks About

GLP-1 medications and hormone therapies have moved from niche to mainstream. About 19% of large employers now cover GLP-1 drugs used primarily for weight loss, according to the Kaiser Family Foundation’s Employer Health Benefits Survey. That figure climbs to 43% among employers with 5,000 or more workers. What wasn’t always part of that design was the clinical infrastructure to support ongoing use. 

Now, new research shows where that coverage stops – and what that gap is costing employers.

GLP-1 and Hormone Coverage: Where It Stops

Maven’s Beyond the Script report surveyed 1,538 women and 520 healthcare providers across the U.S. Thirty-seven percent of women who used medications for weight, metabolism or hormones said follow-up care felt limited, inconsistent or didn’t exist at all. Providers describe similar problems from their side. Forty-one percent said they don’t have enough visit time to support patients after prescribing GLP-1 medications, and nearly half reported uncertainty about when GLP-1s are clinically appropriate in the first place.

Prescription coverage without clinical follow-through carries a price, one that accumulates in claims costs, productivity and retention before most HR teams have a way to measure it. 

The Coordination Cost HR Isn’t Measuring

The reality is, GLP-1s and hormone therapies aren’t one-and-done treatments. They interact with reproductive history, hormonal health, mental health and metabolic function in ways that shift over time. Managing them well requires continuity on top of initial access.

The Maven research provides specifics: Only 19% of women say their hormones are always considered in their reproductive care. More than half suspected their symptoms were connected and were told they weren’t. When healthcare is delivered piecemeal, employees have to pick up the coordination: scheduling appointments, tracking their own health data and moving records between providers who don’t share systems. These healthcare-related tasks pull employees away from the workday in ways that don’t show up in absence records.

Maven’s outcomes data reveals what changes when healthcare is better connected: 60% of Maven members report being more productive at work after getting access to coordinated care. It’s a productivity return that most benefits packages aren’t designed to track.

What Connected Healthcare Can Deliver for Employers

Maven Clinic recently launched a direct-to-consumer platform connecting GLP-1 and hormone care with broader women’s health services across 30-plus specialties. The platform is built on the premise that women’s health conditions don’t exist in isolation.

“What women are experiencing is not a series of isolated issues,” said Dr. Janelle Duah, Maven Clinic’s Associate Medical Director. “Hormonal and metabolic health impacts sleep, cardiovascular health, mental health, reproductive health, and overall quality of life.”

The outcomes are measurable for employers already partnering with Maven. In Maven’s client population, members save $9,600 per birth on average, NICU admission rates are 27% lower and a Fortune 25 client saw $5,500 in per-member healthcare savings with a 14% reduction in total cost of care.

For HR and finance leaders, those figures represent the business case for connected healthcare: the difference between funding a benefit and managing the cost over time. Adding GLP-1 or hormone coverage without a clinical support structure is an expense without a strategy.

Questions to Bring to Your Next Benefits Review

For many HR teams, open enrollment planning is just around the corner, and the cost picture makes this year’s review more consequential than most. Healthcare costs are rising 8.4% annually, with women’s and family health driving an outsized share of those increases. Analysis from Blue Cross Blue Shield projects broad GLP-1 coverage could raise employer premiums by as much as 14%. Employers who added GLP-1 and hormone coverage made an important coverage decision. 

The question now is whether the benefits package is built to support those therapies over time. As you’re preparing for open enrollment or vendor reviews, here are the questions to bring to the conversation: 

• How is clinical follow-up for GLP-1 users structured in your plan, and which vendor is accountable for outcomes?
• Are hormone and metabolic health managed together in your benefits package or split across separate vendors?
• When an employee has overlapping hormonal, metabolic and reproductive health needs, does your benefits package include a provider that can address them together?

Employers that added GLP-1 and hormone coverage early are ahead on access. The next step is building a benefits structure that makes the coverage work.