Q1. Why is a prior authorization (PA) required?
PA is used to control costs and ensure appropriate use. As specialty drug spend grows, payers require more PA to align use with FDA-approved indications.

Q2. What does covering GLP-1s for obesity cost an employer?
Covering GLP-1s can add $30–$70 per member per month (PMPM) depending on uptake.

Q3. Why are so many GLP-1 claims denied initially?
Most denials occur due to missing documentation or benefit exclusions. Based on payer experience, about 80% of appeals are overturned if the drug is FDA-approved and not excluded by plan design.

Q4. How can employers offer access without breaking their budget?
Employers can adopt tiered eligibility criteria, optimize rebates, and evaluate carve-out programs to balance access with affordability.

Q5. What role does Zeprx play with pharmaceutical manufacturers?
Zeprx consults with drug manufacturers on formulary strategy, providing payer insights on rebate structures, launch positioning, and how new therapies may be evaluated.

Q6. How many GLP-1 drugs are coming to market?
About 40 manufacturers are developing GLP-1s, with 16 new obesity drugs expected between 2026–2029.

Q7. How common is obesity in the U.S.?
Roughly 42% of U.S. adults — about 140 million people — live with obesity (BMI ≥30).This is a frequently asked question

Sources: ICER 2025 White Paper; KFF 2024; CDC/NCHS 2023