Lilly, Novo test direct-to-employer approach that could cut out PBMs and lower costs

The GLP-1 giants are the first to try out this new model, but more companies may follow.

By: Kelly Bilodeau • Published Jan. 14, 2026

Can drugmakers find a way around the pharmacy benefit manager model often blamed for rising drug costs? Some pharma companies are giving it a shot by reaching out directly to large, self-insured employers.

For years, employers have sought to streamline their relationships with drugmakers to lower costs. But until recently, there was no clear path around PBMs, the intermediaries who distribute, formulate and process claims. 

These middlemen often charge fees that erode the value of manufacturer rebates, said Drew Wilkins, a managing director at Deloitte, focused on commercial life sciences.

But amid growing political pressure to reduce drug costs and intense demand for GLP-1 drugs, pharma giants Novo Nordisk and Eli Lilly are this month testing a new direct-to-employer model that would allow self-insured companies to negotiate weight loss treatment prices directly with manufacturers. 

The two companies are partnering with Waltz Health, a digital health company with a program that enables companies to purchase drugs at a fixed price. Waltz will administer the program, including patient eligibility, screening pharmacy and prescription-related tasks, as well as offering customer service support.

While these programs are currently limited to GLP-1 medications, Wilkins said they could mark the beginning of a broader shift, with more drugmakers adopting similar approaches and expanding drug offerings. 

“We’re going to begin to see other manufacturers and large employers push on this and identify where it makes sense to have these models and how we can start to see them emerge,” he said. 

Additional manufacturers could join the market as soon as the end of this year and eventually add more drugs. 

“Early Alzheimer’s, other cognitive disorders and diseases like muscle weakening could be interesting candidates for these models, and a way to tap into an eager population trying to think about their overall health and wellbeing in the long run,” Wilkins said. 

Other products may be less suited for the model. 

“I do not expect that you’ll see it in things like rare diseases or oncology,” Wilkins said. 

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