GLP-1 Coverage: Why Employers Are Dropping Access, and What Comes Next w/ Jay Bregman

Send us Fan MailLosing access to a GLP-1 can happen even when treatment is working exactly as intended. A lower BMI, an insurance change, or an employer facing open-ended costs can suddenly turn a prescription into a maze of denials, prior authorizations, and unexpected expenses.In this episode, Ana Reisdorf speaks with Jay Bregman, founder and CEO of Andel, about why traditional insurance struggles to cover high-demand medications and how direct-to-employer purchasing could offer another path. Jay explains how fixed employer contributions can make GLP-1 benefits more predictable, why he believes prior authorizations add unnecessary costs, and what patients can do when their coverage is at risk.They also discuss Medicare access, losing coverage after successful weight loss, options for self-employed people, compounded medications, future GLP-1 competition, and whether access can become more equitable.**IN THIS EPISODE**- Why GLP-1 demand creates problems for traditional insurance- How pharmaceutical middlemen affect medication pricing and access- What direct-to-employer purchasing means- Why employers hesitate to fund open-ended GLP-1 coverage- How fixed employer contributions could make benefits more sustainable- Why successful treatment and a lower BMI can lead to lost coverage- The hidden administrative costs of prior authorizations- What to do if you’re worried about affording your medication- Options for self-employed people without employer assistance- Jay’s perspective on Medicare, compounded medications, competition, and equitable access**ABOUT THE GUEST**Jay Bregman is the founder and CEO of Andel, a healthcare technology platform that enables high-cost medications like GLP-1s to be more accessible through employer benefits. With more than two decades of experience building and scaling companies, Jay brings a strong understanding of how policy, pricing, and market incentives intersect.In developing Andel, he has focused on redesigning access pathways for high-demand, high-cost drugs that traditional coverage models fail to accommodate. His perspective on GLP-1 access and employer responsibility has been featured in Inc., STAT News, and Pharmaceutical Executive. He has also spoken at TEDx and Web Summit about business leadership.Jay appears in this episode in his capacity as Andel’s founder and CEO. His comments about Andel and the pharmaceutical market reflect his experience and commercial perspective.**CONNECT WITH JAY**Andel:https://www.andel.org/Andel Raises $4.5M for Its Employer-Supported Medication Marketplace:https://www.prnewswire.com/news-releases/andel-raises-4-5m-for-its-employer-supported-medication-marketplace-302588465.htmlAndel Launches New Direct-to-Employer Medication Platform:https://www.prnewswire.com/news-releases/andel-launches-new-direct-to-employer-medication-platform-to-make-glp-1s-affordable-for-millions-302709372.html**SPONSORS**This episode includes sponsored messages from Johnson Fitness & Wellness and gutzy Organic.Johnson Fitness & Wellness offers strength-training equipment, cardio machines, recovery products, and expert guidance for a range of fitness levels, spaces, and budgets. Visit https://www.johnsonfitness.com/ and use code GLP1Hub5 for an exclusive offer for GLP-1 Hub listeners.gutzy Organic makes refrigerated fruit-and-vegetable pouches with prebiotic fiber for convenient, produce-based snacking.Learn more at https://gutzyorganic.com/**JOIN THE 21-DAY MEAL CONFIDENCE CHALLENGE**Starting August 17, the GLP-1 Hub Membership’s 21-Day Meal Confidence Challenge will teach you a simple framework for making food decisions at restaurants, parties, potlucks, vacations, and in everyday life.Join for $5:https://glp-1hub.com/challenge**CHAPTERS**00:00 When successful treatment costs you coverage00:21 Why GLP-1 access is getting harder01:45 Meet Jay Bregman02:16 How direct-to-employer purchasing works03:05 Why medication pricing is so complicated07:24 Why health plans are dropping GLP-1 coverage08:59 Why employers hesitate to pay long term09:48 Fixed employer contributions explained10:46 Long-term health versus short-term employment12:47 Sponsor: Johnson Fitness & Wellness14:06 Medicare access and coverage uncertainty16:03 Losing coverage after lowering your BMI16:54 The hidden cost of prior authorizations18:28 What to do if you’re worried about losing access20:07 Options for self-employed patients20:12 Competition and the future of GLP-1 pricing23:13 Can GLP-1 access become more equitable?24:27 Sponsor: gutzy Organic25:05 The future of compounded GLP-1s28:11 Where GLP-1 access could be in five years29:10 Connect with Andel30:13 The 21-Day Meal Confidence ChallengeMORE FROM GLP-1 HUB📬 Get The Steady State, Ana's weekly newsletter with GLP-1 guidance from a dietitian who's on one: http://join.glp-1hub.com🎙 Subscribe wherever you listen to podcasts, and if this episode helped, leave a quick review on Apple Podcasts or Spotify - it's the single best way to help more people find the show.🌐 Shop GLP-1 essentials, meal plans, and recipes: https://shop.glp-1hub.com📷 Follow on Instagram: @glp1hub📺 Watch on YouTube: https://www.youtube.com/@GLP-1hub*Some of the links shared are affiliate links. When you make a purchase, I will receive a small commission at no cost to you. Thank you for supporting the show.*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.