Public Sector

GLP‑1 medications are one of the fastest‑growing drivers of pharmacy spend for self-funded and public sector plans, so sponsors want to understand how coverage decisions are made. A health‑system–owned PBM evaluates GLP‑1s using evidence-based criteria, total cost‑of‑care impact, and responsible utilization management to support sustainable coverage without unnecessary member burden.

A PBM can support employers with union populations by delivering contract‑aligned benefit designs, transparent pricing, and dependable service that meets negotiated expectations. By offering strong member advocacy, broad pharmacy access, and evidence‑based medication management, a PBM helps unions protect member benefits while keeping the plan sustainable.

GLP‑1 medications are one of the fastest‑growing drivers of pharmacy spend for self-funded public sector plans, so sponsors want to understand how coverage decisions are made.

ClearScript’s lens is always sharply focused on net cost, utilization impact, and long-term GLP-1 trend management. Robust coverage policies, clear prior authorization criteria, and vigilant clinical oversight are critical to ensuring these medications are used appropriately and align with plan sponsor objectives. Our approach at ClearScript remains consistent and disciplined: coverage decisions are always individualized and grounded in plan design, clinical criteria, and long-term affordability. Active utilization management and clinical programs are essential for managing both spend and member outcomes. Transparency around net cost and forecasting market trends are central to how we advise clients as GLP-1 dynamics continue to evolve.