2027-2028 GLP-1 Investment Guide
As GLP-1 costs climb and pressure mounts to make a coverage decision, Omada's 2027-2028 GLP-1 Investment Guide offers benefit leaders new metrics for evaluating obesity care strategy, grounded in evidence rather than guesswork.
Drawing on a 5-year microsimulation model of nearly 25,000 Omada GLP-1 members, alongside commercial reimbursement benchmarking, this guide moves beyond the traditional cover/don't-cover binary to quantify where real savings occur across the GLP-1 patient journey.
Summary of guide findings:
- Traditional ROI formulas don't capture the full value of GLP-1 therapy. This guide looks beyond immediate drug costs to quantify medication persistence, companion program engagement, disease risk reduction, and outpatient spending as connected value metrics.
- Medication persistence drives savings. GLP-1 users who persisted for at least 12 months with companion program support demonstrated a 30% estimated cost-savings premium over those who persisted for at least 6 months.
- Companion program engagement can be as financially significant as medication choice. Higher engagement produced an additional $1,174 in average estimated cumulative healthcare savings per member at 5 years compared to lower engagement, nearly matching the $1,164 savings gap between tirzepatide and semaglutide.
- Disease risk reduction builds savings over time. Simulated healthcare savings associated with reduced obesity-related disease onset were estimated at $4,784 per member at 3 years and $8,578 at 5 years among users who persisted on medication for at least 6 months.
- Outpatient savings can show up within the same plan year. When a virtual companion program serves as the primary site for GLP-1 prescribing and management, estimated Year 1 outpatient medical cost avoidance is $790-$1,163 per member, excluding program fees.
For benefits leaders, these findings offer a defensible criteria set for 2027-2028 planning, one that treats GLP-1 medication and companion care as a single connected investment, and includes a practical checklist of questions to ask any program partner before finalizing plan design.
