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This is where health insurance leadership comes together.

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Becker's fourth annual spring payer issues roundtable brings

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together over 400 payer and health plan executives

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and more than 100 speakers to Chicago April.

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This year's event includes keynote conversations with the

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industry's top leaders and former president George W.

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Bush. For the full agenda and event details,

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visit beckershospitalreview.com

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and click on the events tab in the

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upper right. We're looking forward to hosting you

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here in Chicago.

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Hello, everyone. This is Elizabeth Cassello with the

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Becker's Payer Issues podcast.

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I'm thrilled today to be joined by Bethany

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Stein, segment president of pharmacy at Humana.

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Bethany, thanks so much for chatting with us

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today. Yeah. Happy to be here. Thanks for

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having us, Liz.

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Yeah. So before we jump into the conversation,

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can you tell us a little bit more

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about yourself, your health care career background,

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and what your role is at Humana?

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Yeah. Happy to do that.

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Bethany Stein, as Liz said, president of Humana's

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pharmacy segment, CenterWell Pharmacy. I am a pharmacist

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by trade,

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and started at Humana right out of pharmacy

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school as a resident.

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So today, I oversee the strategic growth operations

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and p and l of Humana's three different

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pharmacy businesses, which include

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CenterWell Pharmacy, our home delivery pharmacy,

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CenterWell Specialty Pharmacy, and then Humana Pharmacy Solutions.

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And I would just add that my team's

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focus is incredibly simple. Right? We wanna make

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pharmacy more transparent, more consumer friendly,

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and more clinically effective at scale.

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That's great to hear, Bethany, and thanks again

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for joining us.

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So the big news I wanna talk about

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today is how Humana Centerwell Pharmacy is going

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to dispense Eli Lilly obesity management drugs

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through its employer plan sponsored carve out programs.

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What are employers asking for right now when

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it comes to GLP one coverage, and how

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does this partnership

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enable Humana to respond to that demand?

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Yeah. Thanks, Liz. I love this question. I

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think employers are in a very different place

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with GLP one coverage today than even a

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year ago.

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The conversation has essentially shifted from should we

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cover them to how we cover them responsibly.

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They're looking for predictability,

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control, and transparency,

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but without

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restricting access for the people who truly need

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these medications.

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So what we're hearing consistently from employers is

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that not all GLP one use is the

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same.

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Right? So different employee populations

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have very different clinical needs, whether that's dose

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escalation,

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duration of therapy,

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or just like the type of behavioral support

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required to be successful.

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So employers

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are increasingly asking for benefit designs that stratify

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populations

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thoughtfully,

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rather than treating GLP ones as one large

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undefined cost category.

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So for example,

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some programs that distinguish between

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high risk metabolic patients that may see the

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greatest downstream medical savings. Right? A weight only

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population

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where employers may want more guardrails and accountability.

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And then finally, maintenance versus initiation phases where

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intensity and cost can differ significantly.

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So that kind of segmentation

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helps employers move from this broad utilization

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concern

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to an intentional strategy where they can support

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the right patients without runaway spends.

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And, honestly, Liz, like, the cost pressures are

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real. Right? A recent Gallagher study showed that

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GLP one drug class spend increased 35%

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in 2024

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and another 25%

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in 2025.

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So even with good clinical outcomes, that cost

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trajectory is truly outpacing

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the near term medical savings.

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So employers are rethinking their models and leaning

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into approaches that give them clear line of

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sight to both utilization

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and value.

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And so, again, going back to

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integrating segmentation,

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clinical oversight,

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and a more transparent pharmacy model, we at

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CenterWell are really helping employer structure GLP one

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benefits

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in a way that meets the moment,

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sustainable,

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intentional,

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and still high quality for their members. So,

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ultimately, it's about giving employers the confidence that

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they can offer these important therapies without sacrificing

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affordability

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and giving employees

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a support model that actually helps them succeed.

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So I would just say that is in

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general why we are so excited

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with where we're going in our partnership with

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Lilly and other various partners within this ecosystem.

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Yeah. So I was actually going to ask

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about those other partners just to give context

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to our listeners.

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Humana is also working with Novo Nordisk on

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direct to patient, we go via access.

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And there's also just beyond that, some recent

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research points to slowed medical cost growth for

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g l p GLP one users in the

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long term.

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So how do those collaborations

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with manufacturers

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so Eli Lilly, like what we're talking about

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today, Novo Nordisk,

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work together to bend that cost curve without

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restricting access? Just elaborating a little bit more

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on those stratification points that you mentioned earlier.

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Yeah. I would just say, I think GLP

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ones are both clinically transformational

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and financially challenging at scale. Right? And so

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that's exactly why we're talking about such a

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deliberate approach.

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So Humana

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is building a consumer focused health care company,

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and pharmacy is a strong expression of just

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that strategy.

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Whereas CenterWell Pharmacy, just as as background information

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for you all, is was built originally for

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the health plan by the health plan. So

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from day one,

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it has been designed around outcomes,

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transparency, and affordability,

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not spread pricing, rebate fees, or intermediaries.

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And so we have results that really speak

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for themselves in the form of better outcomes.

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Right? CenterWell patients have

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15% fewer ER visits and 13%

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lower hospitalizations

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than patients using any other pharmacy in our

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network, and we validate that annually.

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We see better experience.

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Right? Our net promoter score is consistently 15

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points higher than other pharmacies.

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We we deliver that true transparency. Right? So

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for thirty years, we've operated with no hidden

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fees, no gains, and complete visibility for the

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health plan.

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And then lastly, affordability

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is just built into our model. Right?

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At at the highest level, 90% of our

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generics cost less than $2 a month, many

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with no co pay at all.

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And we truly proactively

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help members find lower cost alternatives

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and financial assistance for high cost brands and

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specialty drugs.

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So when you combine all that

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with home delivery

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scale and a consumer first mindset,

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you really end up with a pharmacy model

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that is uniquely aligned to what the GLP

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one marketplace requires,

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predictable pricing and clinical integrity.

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And so that's why we're expanding this model

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beyond Humana members to a direct to patient

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pharmacy solution model for GLP ones. And so

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to get to your question,

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our collaborations with manufacturers like Novo Nordisk and

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Eli Lilly are built upon those same principles.

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We just simplified access at a lower out

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of pocket cost. And so this truly does

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bend the cost curve and expand access,

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and we're doing it

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exactly how a consumer health care company should

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do it. Right? Simplifying the ecosystem,

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removing friction and waste,

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delivering predictable transparent pricing,

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improving outcomes and adherence,

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and scaling safely and responsibly.

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So we're not restricting access. We're expanding safe,

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affordable, high quality access

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while building a cost structure that is sustainable

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for payers, employers, and consumers over the long

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term.

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And I believe that this is really the

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future of pharmacy care. Right? A consumer centric,

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clinically guided, transparent,

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and and it's built to support the next

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generation of therapies at scale.

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So I actually wanted to ask a little

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bit about that adherence point because that is

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such a concern here.

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What

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steps is Humana taking while they're working

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with employers

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on promoting adherence?

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And what what else do you have to

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say on adherence?

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Because that is just such a big concern

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in terms of the cost here.

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Yeah. I totally agree. And if you if

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you taking a step back, I would say

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the strongest support around medication adherence

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is a lot of the clinical programs and

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support elements that we have in place today.

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So just another metric for you. At CenterWell

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Pharmacy, we see about 260 basis points better

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medication adherence than we see in other pharmacies

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in our network. And so our pharmacy is

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truly incentivized

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to to focus on adherence because we know

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there is a ton of downstream clinical impacts

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related to that. The hospitalizations

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I mentioned, the ER visits,

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those are all

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lowered, and this is well studied in the

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industry, when patients take their medicines.

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Right? And so I would say at CenterWell

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Pharmacy, we have

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robust medication adherence programs

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that are in all forms, whether it be

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reminder calls or having conversations with pharmacists around

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barriers to adherence.

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We segment the population

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on those that are high risk of falling

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out of medication adherence

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versus ones who we know may just need

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a little bit of a nudge or a

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lower cost intervention.

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So we've done a ton of research on

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this. I would say we have a ton

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of clinical interventions, and I'm really proud of

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the investments that we have made to support

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medication adherence

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because it is a win win solution when

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members take their drugs. We just see the

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better better medical outcomes

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that that result.

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Yeah. Absolutely. And you mentioned this earlier, but

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you think that employees are

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shifting their perspectives on GLP ones at least

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in the past year.

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Could you talk a bit more about why

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now is the time to deepen relationships with

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manufacturers

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offering weight loss drugs?

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Yeah. It's it's a great question.

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The health care system is under pressure to

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lower drug costs and expand access. Right? Creating

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a truly a favorable environment for an alternative

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benefit model. The system does need a new

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model,

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and both manufacturers

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and employers know that they cannot solve this

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alone.

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So the environment,

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I would say, today makes partnerships like ours

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especially valuable

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because they deliver on what the market is

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demanding right now. But just going back, I

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mean, GLP ones were definitely the catalyst, and

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here's why. I mean, one, affordability

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was and still is a top concern for

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regulators and legislators,

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and access to GLP ones

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were declining.

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Two, drug shortages at the time exploded. Right?

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And the market was flooded with compounds and

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non FDA approved alternatives,

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creating real safety risks.

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Three,

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manufacturers were looking for a way to disrupt,

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and we became that partner.

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Starting with our partnership last year with Novo

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Nordisk for Wegovy,

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and now with Eli Lilly.

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Together, we've lowered costs, helped patients avoid unsafe

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alternatives, and addressed barriers to access and affordability.

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And I wanted to hear some final thoughts

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and advice as we wrap up for other

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industry leaders. And I know

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you mentioned a lot about what CenterWell does

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really well, but what advice do you have

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also for payers that might not have a

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pharmacy component

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and what they could be thinking about right

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now?

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Yeah. If there were

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if there's one takeaway from our experience, it's

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this. The GLP one moment isn't just about

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GLP ones. It's about rethinking the entire ecosystem

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around access, access, affordability, and consumer experience.

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My advice is simple. Right? Start designing

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for the consumer first. When you build models

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that prioritize

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transparency,

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clinical quality, and predictable cost, you don't just

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improve access. You naturally bend the cost curve

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because the system becomes simpler.

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Second, leaning into partnerships. None of this none

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of us can solve the drug affordability and

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access challenge alone.

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Manufacturers,

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pharmacies,

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payers, and employers

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each control a different lever. So when those

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work together, like our collaborations with Eli Lilly

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and Novo Nordisk, you can really create access

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channels that are clinically responsible,

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financially sustainable, and scalable.

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And then just finally,

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embracing transparency and data.

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The organizations

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that win in this space will be the

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ones who can demonstrate real outcomes,

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drive medication adherence,

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and give payers and employers true line of

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sight into utilization and value.

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So that obviously requires openness,

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shared data, and a willingness to rethink long

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standing structures in the pharmacy supply chain.

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We're at a pivotal moment in health care,

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and if we design with the consumer in

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mind, commit to responsible collaboration,

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and build models that are transparent by default,

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we can expand access to transformational therapies like

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GLP ones

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while keeping the system sustainable for everyone.

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Well, thank you, Bethany, so much for joining

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us today. It was great to get a

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bit more context on your collaboration with Eli

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Lilly. And to our listeners, if you'd like

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to listen to more podcasts from Becker's HealthCare,

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you can visit beckershospitalreview.com.

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Bethany, thanks again, and have a nice day.

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Thanks, Liz. You too.