Podcast Summary

Becker’s Healthcare Podcast

Episode: Rethinking GLP 1 Coverage Through Transparent, Consumer First Pharmacy Models
Date: January 24, 2026
Host: Elizabeth Caslo (Becker’s Healthcare)
Guest: Bethany Stein, Segment President, Pharmacy at Humana

Episode Overview

This episode explores Humana's evolving pharmacy model in response to employer demand for responsible GLP-1 (obesity management drug) coverage. Bethany Stein discusses their partnerships with manufacturers like Eli Lilly and Novo Nordisk, providing insight into transparent, consumer-centric pharmacy models that aim to balance access, affordability, and adherence for weight loss medications.

Key Discussion Points & Insights

1. State of GLP-1 Coverage Among Employers

• Employers are shifting from questioning “if” they should cover GLP-1 drugs to determining “how” to cover them responsibly ([02:05]).
• Priorities: Predictability, control, and transparency—without restricting access for those in need.
• Employers now favor benefit designs that stratify populations based on clinical need (e.g., high-risk metabolic, “weight-only,” and phase-based use), rather than treating GLP-1s as a monolithic cost ([02:38]).

2. Rising Costs and the Need for Strategic Segmentation

• GLP-1 spend has risen rapidly: up 35% in 2024 and 25% more in 2025 (Gallagher study cited) ([03:33]).
• Employers require clearer models to balance cost with value.

  “So that kind of segmentation helps employers move from this broad utilization concern to an intentional strategy where they can support the right patients without runaway spends.” – Bethany Stein ([03:11])

3. Partnership Model with Eli Lilly and Novo Nordisk

• Humana collaborates with manufacturers for direct-to-patient GLP-1 access, aiming for better cost and access outcomes ([04:44], [05:18]).
• Centerwell Pharmacy serves as an extension of Humana’s consumer-first mission: no hidden fees, transparent pricing, focus on clinical outcomes.
• Metrics: 15% fewer ER visits and 13% lower hospitalizations among Centerwell patients compared to other pharmacies ([06:22]).

  “We deliver that true transparency, right? So for 30 years we've operated with no hidden fees, no games and complete visibility for the health plan.” – Bethany Stein ([06:46])

• Most generics cost <$2/month; proactive support for affordable alternatives ([07:04]).

4. Bending the Cost Curve While Protecting Access

• The partnership model is designed to simplify access, reduce out-of-pocket costs, and maintain predictable spend ([07:38]).
• Centerwell’s approach: expand access while safeguarding quality and affordability for payers, employers, and consumers ([07:55]).

  “We're not restricting access, we're expanding safe, affordable, high quality access while building a cost structure that is sustainable for payers, employers and consumers over the long term.” – Bethany Stein ([08:03])

5. Medication Adherence as a Key Success Factor

• Adherence improves outcomes and reduces costs. Centerwell’s adherence rates surpass those of other pharmacies by 260 basis points ([08:37]).
• Interventions: reminder calls, pharmacist-led barrier assessments, population segmentation by adherence risk ([09:12]).

  “When members take their drugs, we just see the better, better medical outcomes that that result.” – Bethany Stein ([09:48])

6. Why Now? The Rationale for Deeper Industry Collaboration

• Increased attention from regulators and payers on affordability and safe access ([10:23]).
• Drug shortages and non-FDA alternatives created patient safety risks.
• Market dynamics (cost/control) have created opportunities for alternative benefit models anchored by strong payer-manufacturer partnerships ([11:01]).

  “The environment, I would say today makes partnerships like ours especially valuable because they deliver on what the market is demanding right now.” – Bethany Stein ([10:33])

7. Advice to Other Industry Leaders and Payers

• Rethink the ecosystem for access, affordability, and experience ([11:55]).
• Design with the consumer first; prioritize transparency and predictable cost.
• Lean into partnerships; no single entity can solve these challenges alone.
• Embrace data, transparency, and flexibility in benefit designs ([12:33]).

  “The GLP-1 moment isn’t just about GLP-1s. It’s about rethinking the entire ecosystem around access, affordability and consumer experience.” – Bethany Stein ([11:56])

Notable Quotes & Memorable Moments

• On strategic segmentation:
  “Employers are increasingly asking for benefit designs that stratify populations thoughtfully rather than treating GLP1s as one large undefined cost category.” – Bethany Stein ([02:37])

• On transparent, consumer-driven pharmacy:
  “We want to make pharmacy more transparent, more consumer friendly, and more clinically effective at scale.” – Bethany Stein ([00:26])

• On the pharmacy’s impact:
  “Center well, patients have 15% fewer ER visits and 13% lower hospitalizations than patients using any other pharmacy in our network.” – Bethany Stein ([06:22])

• On cost-containment and value:
  “When you build models that prioritize transparency, clinical quality and predictable cost, you don’t just improve access, you naturally bend the cost curve because the system becomes simpler.” – Bethany Stein ([12:01])

Timestamps for Key Segments

• 00:59 – Bethany Stein’s background & Humana role
• 02:05 – Employer GLP-1 coverage demands & design trends
• 03:33 – Rising GLP-1 costs and need for segmentation
• 04:44 – Partnerships with manufacturers, direct patient access
• 06:22 – Centerwell’s outcomes & transparency model
• 07:38 – Expanding, not restricting, access to GLP-1s
• 08:37 – Medication adherence strategies at Centerwell
• 10:23 – Why now is the time for deep manufacturer-payer partnerships
• 11:55 – Advice for industry: transparency, collaboration, data sharing

Concluding Takeaways

• The surge in GLP-1 demand and costs is driving a rapid reevaluation of pharmacy benefit models.
• Transparent, consumer-focused approaches—like Humana’s Centerwell—can bend the cost curve without sacrificing access.
• Strong, direct partnerships with pharma manufacturers are seen as essential to sustainable, scalable benefit models.
• Medication adherence programs are central to achieving clinical and economic outcomes.
• The episode calls on healthcare leaders to design for the consumer, embrace partnership, and foster full transparency for a sustainable pharmacy ecosystem.