| It’s unsurprising that Eli Lilly, the maker of blockbuster GLP-1 medications Zepbound and Mounjaro, wants more people on GLP-1s. But what is noteworthy is the path they’re taking to get there. Eli Lilly CEO Dave Ricks estimates that more than 100 million people in the United States are candidates for the drugs. “That’s about as big as it gets if you think of total addressable markets in our sector,” Ricks told reporters during a roundtable Tuesday. Yet he says roughly 1 out of 9 people eligible for the drugs are actually using them. “Seems like it should be a lot more,” Ricks said. The company is leveraging federal models to test an expansion of the drug to treat obesity for patients enrolled in Medicaid and Medicare, but there’s also an effort to get more employers to cover GLP-1 drugs, as some companies reconsider whether they can afford the benefit. Roughly half of U.S. employer-covered people currently have access to obesity drugs, a figure Ricks said has remained largely unchanged. Eli Lilly is betting that more transparent pricing and new ways for employers to buy the drugs can change that. Earlier this year, the pharma giant launched its Employer Connect platform that lets employers work through outside administrators to offer GLP-1s at discounted prices, rather than operating through the traditional pharmacy benefit managers (PBMs). The pitch is that employers can more easily calculate what the benefit will cost rather than navigating the rebates and fees built into the traditional PBM system. So far, dozens of companies have enrolled, Kevin Hern, senior vice president of Lilly Employer, told reporters. “We built it around some of the tensions and challenges we were hearing from employers that were maybe keeping them on the sidelines,” Hern said. Eli Lilly is also directly contracting with the nation’s largest employers to provide the meds. However, even with discounts, the monthly cost to employers for higher doses of Zepbound can be upward of $400 per patient. The push comes as reports are showing that employers are trying to tamp down costs amid the continued increase in coverage costs. Health insurance costs are projected to jump by 8.2 percent in 2027 — the largest increase in decades. There’s a fresh report from The Post’s Julie Z. Weil that explores how employer plans are handling coverage of GLP-1s for weight loss, including imposing stricter requirements needed for workers to get them. And it points out that large employers PepsiCo and Cigna are dropping coverage of the medications to treat obesity. (Ricks laments that companies dropping coverage makes the news, but employers adding GLP-1 coverage rarely does.) → While two-thirds of companies currently cover drugs for weight loss, according to the employer organization Business Group on Health, 10 percent plan to drop the coverage next year. Pharmaceutical companies have been trying to emphasize the longer-term savings they argue stem from people taking the drugs. But, in order to reap any of those benefits, people obviously take the medications as prescribed. One JAMA study published this summer showed that cost of these drugs is the most substantial barrier to staying on them, even among people with commercial insurance. Researchers found that adherence, which was already low, dropped even more once the monthly cost exceeded $75. Insurance coverage can make the drugs vastly cheaper out of pocket for consumers, but I asked Ricks how he planned to further reduce the price of the medications. He said that he expects prices to fall once competition increases and new treatments hit the market. “For those that don’t have insurance, we offer the best rate available. For those that do, we want to get coverage through insurance. That’s the path we’re pursuing,” Ricks said. “I would expect those price points to drop, but the value points are rising.” Nicole Saphier’s confirmation hearing to be the nation’s top doctor had a vaccine-heavy focus. During the Senate Health, Education, Labor and Pensions Committee hearing, she backed childhood immunization — even as the administration she would join has pushed to rethink federal vaccine guidance. Senate HELP Chairman Bill Cassidy (R-Louisiana) said that Americans will look to Saphier for “clear medical guidance,” and repeatedly quizzed her on her stance on several vaccines. She ultimately said “I do not believe childhood vaccines cause autism” after Cassidy pressed several times on whether she thinks there is a link between routine childhood vaccines and autism —and asking her not to equivocate. Saphier also said she supported the universal birth dose of the hepatitis B shot, which public health experts credit with decreasing the disease in children by 90 percent. Saphier’s comments put her at odds with an administration that has repeatedly questioned vaccine safety and the established evidence that vaccines do not cause autism. The Trump administration has moved to drop the long-standing recommendation to give all newborns the hepatitis B vaccine. (The policy has been temporarily blocked by a federal judge as part of an ongoing lawsuit.) Last month, President Donald Trump said the combined measles, mumps and rubella (MMR) vaccine could be “quite lethal,” without citing scientific evidence. He has pushed to split the shot into three separate vaccines, which would require years of additional research and development by the companies that make it. The Post’s Rachel Roubein has a story about the hearing that tracks Cassidy’s quest for answers on vaccine policy. At the outset of the hearing, Cassidy said that the nation’s worst measles outbreak in the United States in 35 years is “going to be a terrible legacy for this administration,” citing recent deaths in Pennsylvania. Meanwhile, Sen. Susan Collins (R-Maine) pressed Saphier on whether she agreed with a Food and Drug Administration decision to allow flavored vapes on the market, which Collins said entices children to use them and contributes to youth vaping. Saphier acknowledged the dangers of nicotine for children, but said that flavored vapes could be an effective tool in helping adults quit smoking combustible cigarettes. “I understand where the concern is there. … I do believe that if a flavor can entice an adult to quit smoking cigarettes, then maybe it’s something to be considered,” Saphier said. “There are other smoking-cessation devices like nicotine gum that are also flavored, and … we don’t have the same concern for the appeal for the youth. But I would look at the data. I would work with the FDA, and I would present a clear, concise message to the American people.” Trump selected Saphier to be the U.S. surgeon general in April. It’s the administration’s third attempt to fill the role. Saphier is a former Fox News contributor and radiologist at Memorial Sloan Kettering Cancer Center, a gig that earned her more than $955,000 in salary and overtime, according to her financial disclosure form. She earned more than $295,000 in consulting fees from Fox News and about $66,000 from her “Wellness Unmasked” podcast. In 2020, she authored a book called “Make America Healthy Again: How Bad Behavior and Big Government Caused a Trillion-Dollar Crisis,” encouraging Americans to take better care of themselves. → If confirmed as surgeon general, Saphier said she would divest thousands of dollars’ worth of stock in dozens of companies, including Johnson & Johnson, fast food company Yum! Brands and tobacco giant Philip Morris International, according to federal ethics disclosure forms. She’s also pledging to resign from Empower MD, her company that owns DropRx and which netted her more than $270,000, according to the federal disclosures. DropRx sells herbal tinctures and dietary supplements. “Trump Administration Shift Puts This Corner of Biotech Back in Favor,” the Wall Street Journal’s David Wainer reports. “CMS to add more chronic conditions to ACCESS model in 2027,” Anuja Vaidya writes for Healthcare Dive. “CDC director’s ‘unusual’ silence draws scrutiny,” reports The Hill’s Nathaniel Weixel. “Rising Healthcare Costs Have Hit Georgia’s Most Conservative District. But Its Politics Are Unlikely To Change.,” Briah Lumpkins reports at KFF Health News. This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from The Washington Post newsroom. Learn more about WP Intelligence. | 
