Novo Nordisk and Eli Lilly are setting up direct contracting channels with self‑insured employers to offer high‑cost obesity medications, bypassing some traditional distribution and PBM pathways. Waltz Health announced a direct‑to‑employer program to enable self‑insured firms to contract for GLP‑1 products and integrated care for employees. Companies argue the moves expand access and control costs for employers; payers and PBMs see them as disruptive to established benefit management models. Direct contracting raises operational questions — from supply logistics to benefits design and monitoring of clinical outcomes — that employers must address. The changes could accelerate employer‑driven purchasing models for specialty medicines and intensify pressure on pricing and reimbursement strategies across the obesity drug market.