How direct-to-employer GLP-1 purchasing works, with Jay Bregman of Andel

How direct-to-employer GLP-1 purchasing works for physicians

Direct-to-employer drug purchasing lets employers buy brand-name drugs straight from the manufacturer, bypassing the pharmacy benefit manager (PBM) and insurer, and pass the discount to their workers. It's the model behind Andel, a cooperative that launched its medication platform in March 2026.

Medical Economics sat down with founder and CEO Jay Bregman to walk through how it works and what it changes for the physicians whose patients are starting to encounter it.

Related content: What direct-to-employer GLP-1 purchasing means for primary care physicians

For clinicians, Bregman's pitch leans on what's removed rather than added. Because Andel runs a licensed pharmacy on the Surescripts network, a physician sends the prescription the same way they would to any retail pharmacy, and the fill flows into the patient's record through the usual e-prescribing rails. There's no prior authorization, no step therapy and no utilization management standing between the script and the fill.

However, access is tied to a job and an employer's willingness to keep paying. Bregman says COBRA — that is, the Consolidated Omnibus Budget Reconciliation Act — may let some plans continue the benefit and that portability between employers is on the company's roadmap, but for some drugs the negotiated price disappears once the contribution runs out or a patient leaves.

The conversation also covers why Bregman argues traditional coverage barely works in practice (by his account, fewer than 2% of plan members get access even when GLP-1s are covered), how Andel's data feed to plans differs from direct-to-consumer channels (a claim an outside party can't yet verify), and where the model sits alongside the new Medicare GLP-1 Bridge, which begins July 1 and extends $50-a-month access to eligible Medicare Part D beneficiaries through the end of 2027.