How Commercial Insurers, Self-Insured Employers, PBMs, and Manufacturers Are Turning GLP-1 Pharmacy Benefits Into Active Managed-Access Operating Systems and Where the Infrastructure Opportunity Sits

KFF 2025 data shows 43 percent of firms with 5,000 or more workers now cover GLP-1s for weight loss, up from 28 percent in 2024. But the headline coverage rate understates the real complexity. Each employer, carrier, and PBM is building a different managed-access architecture on top of their formulary, and those architectures are creating new infrastruc…