GLP-1s Still Making Headlines

Glucagon-like peptide-1 (GLP-1) receptor agonists continue to be one of the most closely watched therapy classes in 2026. Originally developed for Type 2 diabetes, GLP-1 medications have seen rapid expansion into weight management and broader cardiometabolic conditions. Their ability to improve satiety, reduce blood glucose, and deliver sustained weight loss has driven ongoing demand.

Recent updates include the FDA approval of oral Wegovy (semaglutide) tablets, rise of direct-to-consumer channels, and federal government actions that could impact the overall market.

Newer agents—including combination therapies, next generation multi-agonists, and upcoming oral GLP-1s—are expected to further accelerate growth throughout 2026 and beyond.

How Premera covers GLP-1 medications

Premera uses two distinct policy pathways for GLP‑1 coverage, depending on indication and employer group benefit design.

1. GLP-1s for Type 2 diabetes (covered across all plans)

GLP-1 medications approved for Type 2 diabetes follow the standard diabetes medical policy. Coverage requires:

• A documented diagnosis of Type 2 diabetes
• Meeting all medical necessity criteria

Updated quantity limits went into effect in January 2026 to support consistent, appropriate utilization.

2. GLP-1s for weight management (employer-elected benefit)

Weight management GLP-1s are reviewed under the weight-loss drug policy and are only covered when an employer group elects this benefit.

For those groups:

• FDA-approved weight-loss GLP-1s such as Wegovy and Zepbound require prior authorization approvals.
• Clinical criteria, dose checks, and utilization safeguards apply.
• Quantity limits are in place to help ensure safe and appropriate use.

If a group doesn’t elect weight-loss drug coverage, GLP-1s for obesity are not covered.

Key takeaways

• Expect continued growth in utilization.
• Maintain strong utilization management to ensure clinically appropriate prescribing.
• Monitor for mid‑year benefit and pricing updates as new products enter the market.

Premera will continue providing updates as the GLP-1 landscape evolves.

View the complete formulary update for February 2026.