News & Insights
VENTEGRA OFFERS VALUE-DRIVEN STRATEGY TO HELP PAYORS NAVIGATE SOARING GLP-1 DEMAND
Evidence-Based, Transparent, and Tailored Solutions to Manage Cost and Access
GLENDALE, CA – Ventegra, a Nonprofit Public Benefit Corporation that has been pioneering Medical Benefit Management (MBM) solutions for more than 20 years—delivering innovative, value-driven pharmacy and medical benefits that balance drug spend control with quality patient care— has launched a comprehensive, evidence-based approach to help payors make sustainable, data-driven decisions about GLP-1 access and reimbursement.
GLP-1s, initially approved to treat type 2 diabetes, are now widely sought after for weight loss, obesity and other therapeutic effects.
Ventegra recognizes that the turbocharged demand for GLP-1 receptor agonists like Ozempic®, Wegovy®, Mounjaro®, Zepbound® has created a pressure-cooker environment for U.S. payors to manage skyrocketing drug costs while ensuring equitable patient access.
The Ventegra approach to GLP-1s aligns with its approach to every drug on its formulary: grounded in its pharmacoeconomic and therapeutic values that includes quarterly review by a multidisciplinary team, ensuring that current clinical evidence, real-world data, and evolving medical guidelines shape the access strategy. This ensures GLP-1 coverage is aligned with true therapeutic value and clinical effectiveness, not marketing momentum.
Michael Shannon, M.D., Ventegra’s Medical Director and a board-certified endocrinologist on the University of Washington faculty, explains, “GLP-1 agents have proven benefits in reducing obesity and blood sugars, and some have emerging evidence in improving cardiovascular outcomes and other comorbidities. These are expensive medications, however, Ventegra can work with clients to help them weigh these tradeoffs in line with their preferences and values.”
Robert T. Taketomo, PharmD, MBA, President & CEO of Ventegra, Inc. and Chairman of the Board of the Ventegra Foundation, adds, “As a company run largely by pharmacists and pharmacy technicians, we remain a clinically driven organization. Our status as a nonprofit allows for this clinical focus instead of a financial one like the traditional pharmacy benefit management (PBM) industry. We intend to further share our expertise through our Ventegra University that will provide our policies and guidelines to the public.”
With its well-earned reputation for transparency and integrity, Ventegra’s cost-saving offerings for GLP-1s, as with all drugs on its formulary, go beyond traditional PBMs to reduce costs, improve clinical outcomes, and ensure regulatory compliance for a diverse range of clients nationwide.
Mark Shinmoto, Pharm.D., Vice President of Clinical Programs, further clarifies, “Our Clinical Advisory Committee, which is comprised of unbiased healthcare professionals, provide us with the valuable insight to craft our drug utilization strategies based on quality and cost. We incorporate the information available from organizations such as ICER and NICE, along with peer reviewed, evidence based medical societies, to ensure our policies and guidelines are consistent with those used by reputable agencies throughout the world.”
Operationally, Ventegra tailors appropriate step edits and prior authorization (PA) alongside consulting with clients on benefit design strategies to streamline access and minimize delays—reducing friction for both providers and patients. Custom plan designs, backed by detailed payor consultations, help ensure that coverage criteria reflect the payor’s values, risk profile, and cost containment goals. The result is seamless implementation and measurable savings
Guided by a mission-driven, nonprofit model and a bold 100-year vision, Ventegra operates free from shareholder and private-equity pressures to advance transparent, sustainable, and ethical healthcare practices.
To explore how Ventegra, a force for good in the healthcare industry, can support your organization with payor aligned solutions and measurable results, visit www.ventegra.org
About Ventegra, Inc.
Ventegra uses innovative and proprietary programs and products to ensure appropriate use of prescription drugs while lowering our clients' costs. As a Medical Benefit Manager (MBM), Ventegra is a new class-of-trade healthcare model that helps clients gain efficiencies, lower expenditures, and improve the overall quality of care. Ventegra's offerings include innovative, cost-saving solutions designed for medical groups, health systems, self-insured plans, TPAs, government entities, brokers, consultants, and nonprofits. www.ventegra.org
About Ventegra Foundation
Ventegra Foundation is a Nonprofit Public Benefit Corporation. Its mission is to establish new channels for delivering better efficiencies and more cost-effective healthcare for the community that is served. A complex transition process has been initiated that will transfer the intellectual property and personnel of Ventegra, Inc. into Ventegra Foundation. www.ventegra.org
