MAXIS Global Benefits Network (MAXIS GBN) has published a whitepaper identifying captives and other self-funded arrangements as a route to affordable, clinically governed GLP-1 coverage in multinational employee benefits (EB) programmes. The paper, How can employers build an effective GLP-1 employee benefits strategy? Insights from MAXIS data, draws on MAXIS GBN medical claims data covering 52 insurance partners in 36 countries, more than 7.9 million insured lives, over 1.5 million unique claimants and approximately 50 million claims records. The dataset does not cover the US. The whitepaper states that such structures give multinationals greater flexibility to design targeted coverage and negotiate directly with insurers. A multinational writing an EB programme through a captive becomes the ultimate risk bearer, and gains the power to cover claims that may not be possible under the terms and conditions of a local insurer. That allows the employer to choose whether to offer GLP-1 coverage in a given market, regardless of local insurer policies. The paper adds that a captive can reinvest underwriting profits into wellbeing initiatives, wraparound care or the additional pharmacy costs associated with GLP-1 coverage. Where a comprehensive GLP-1 programme is written through an EB captive, that flexibility should be accompanied by stronger governance, including clear clinical criteria, privacy safeguards, independent outcomes assessment and transparent reporting to the employer and insurer. On eligibility, the whitepaper says a captive cannot rewrite local prescribing law but can prevent a generic body mass index (BMI) threshold from becoming an unnecessary barrier to earlier identification and care. It adds that traditional pharmacy-management tools, including formularies, prior authorisation, clinical eligibility criteria and step therapy, remain important but are not sufficient on their own to optimise long-term outcomes. MAXIS GBN claims data shows that 38 per cent of claimants across the global portfolio live with at least one chronic condition, and that these conditions account for 58.4 per cent of total claims paid across the network in 2025. More than one in four chronic disease claimants may be eligible for GLP-1 therapy on the basis of claims-recorded underlying conditions, while 5 per cent of that population currently receives the medication. The data also records low treatment persistence. One in three employees on GLP-1s discontinues treatment after one year. A further 5 per cent stop for a year before resuming after weight rebound, and 6 per cent remain on treatment for more than three years. Comparing claimants receiving GLP-1 therapy with potentially eligible non-users, the analysis identifies a 1,754 per cent greater increase in paid claims spending for depression and a 4,053 per cent greater increase for anxiety. Musculoskeletal and gastrointestinal spending also rises more sharply among GLP-1 users. Other categories move in the opposite direction, with a 65 per cent greater reduction for knee pain and a 33 per cent greater reduction for chronic kidney disease. Leena Johns, chief health and wellness officer at MAXIS GBN and author of the whitepaper, says: "GLP-1s shouldn’t be viewed simply as weight-loss drugs, their role is expanding rapidly. GLP-1s can become part of a broader strategy to intervene earlier in chronic disease and improve workforce health. But planned poorly, employers risk dramatically increasing their pharmacy costs without benefiting from long-term improvements in their people’s health." Johns adds: "Employee demand for GLP-1s is not on the horizon: it’s already here. The question is whether employers are prepared to invest in the wraparound support required to build and sustain an effective strategy." Richard Reyf, director of health and wellness data analytics at MAXIS GBN, says in the whitepaper: "Our global claims data shows that countries are effectively running different approaches to GLP-1 implementation. Some have integrated multidisciplinary support around treatment, while others have focused primarily on medication access." MAXIS GBN is an international employee benefits network co-founded by MetLife and AXA in 1998, providing employee benefits solutions to clients in more than 100 markets. The whitepaper is available at maxis-gbn.com/glp1.
