Omada Health
Between-visit cardiometabolic care with a GLP-1 companion track
Founded 2011 · San Francisco, CA · Public · Website
Our verdict
Buy it as a companion, not a solution. Omada will not lower your pharmacy trend on its own, but it is the strongest evidence-backed way to make the spend you are already committed to actually produce durable outcomes.
Scorecard
How it scored
Scored against the published rubric. Weights are fixed before review and identical for every vendor.
Prescriber credentials, titration protocol, comorbidity screening, and off-ramp planning.
Quality of published results: peer review, sample size, control group, and follow-up duration.
Ability to hold net pharmacy spend down: gating, biosimilar strategy, and risk sharing.
Eligibility-level reporting, claims feeds, and whether you can audit the vendor's own numbers.
PBM, carrier, HRIS, and point-solution interoperability without custom engineering.
Time to first appointment, app quality, care-team continuity, and support responsiveness.
Analysis
What we found
Omada is the most defensible purchase in the companion tier, largely because it does not overclaim. It has spent a decade building cardiometabolic coaching infrastructure and has the published evidence to match, which is rare in this market. The GLP-1 track is explicitly a wrapper: it assumes the drug is prescribed elsewhere and concentrates on the two things that actually determine long-term value — adherence during titration and lean-mass retention on the way down. For a benefits team that already has PBM controls in place, this is the lowest-regret addition on the market.
Strengths
- Deepest published evidence base of any vendor in this set, and it is externally reviewed rather than self-published
- Integrates cleanly with existing PBM pathways instead of fighting them for control of the prescription
- Reporting is genuinely auditable — you get member-level engagement data, not just a quarterly slide
Limitations
- Does not prescribe, so it cannot directly gate or reduce your drug spend
- Requires a separate GLP-1 access strategy, which means a second vendor or PBM negotiation
- Engagement floors mean you pay for enrolled members who go quiet
Best for
Employers whose PBM already controls GLP-1 access and who need durability and lean-mass protection around it.
Watch out
Confirm exactly which fees are at risk and how engagement is defined — the definition moves the guarantee more than the percentage does.
The details
Commercial and clinical specifics
The facts you will need to build a comparison grid. Verify each against the vendor's own documentation before contracting.
Pricing
- Model
- PMPM on enrolled members, with an engagement floor
- PMPM range
- $32–$58
- Setup fee
- Waived above 5,000 lives
- Medications included
- No
- Performance guarantees
- Engagement and weight-loss guarantees; typically 15–25% of fees at risk
Contract
- Minimum lives
- 1,000
- Term
- 24 months
- Termination notice
- 90 days
Eligibility
- BMI threshold
- BMI ≥ 27 with comorbidity, or ≥ 30
- Prior authorization
- No
- Step therapy
- No
- Comorbidity required
- No
Clinical model
- Prescribes
- No
- Care team
- Registered dietitians, CDCES-certified coaches, Exercise physiologists
- Titration protocol
- Not applicable — prescription stays with the member's own clinician or your PBM pathway
- Off-ramp
- Structured 12-week taper support with strength programming to defend lean mass
- Formulary
- Companion to any GLP-1, No direct prescribing
Outcomes evidence
- Headline claim
- 5.5% average weight reduction at 12 months in its prevention programme, with a 2025 analysis reporting weight largely maintained across the year after GLP-1 discontinuation
- Evidence level
- Peer-reviewed observationalPublished cohort data, no randomization.
- Sample size
- Multi-thousand member cohorts; the 2025 GLP-1 analysis covers members discontinuing therapy
- Follow-up
- 12 months, with a separate post-discontinuation analysis
Sources
- Evaluation of a digital behavioral counseling program (PMC)Peer-reviewed evaluation of the behavioural programme
- Duke-Margolis HV-EQ profile: Omada HealthRecords 5.5% average weight reduction at 12 months
- Omada analysis on long-term weight maintenance after GLP-1sCompany analysis, November 2025
Outcomes verified 2026-09-19. Pricing and contract figures on this page are category planning benchmarks, not vendor quotes — see methodology.
Integrations
- PBMs
- CVS Caremark, Express Scripts, Optum Rx
- Carriers
- Aetna, Cigna, UnitedHealthcare, BCBS plans
- HRIS
- Workday, ADP, UKG
- Eligibility file
- Standard 834 or flat file, weekly cadence
Formulary
Omada Health by medication
How a vendor positions each molecule reveals more about its cost discipline than any single score. First-line means an eligible member can start immediately; escalation means a documented lower-cost trial comes first.
Omada Health Reviews Semaglutide
GLP-1 receptor agonist
Omada writes no prescription. It wraps a semaglutide script issued by your PBM pathway or the member's own clinician, concentrating on the escalation window where discontinuation clusters and on protein and resistance programming to defend lean mass.
Omada Health Reviews Tirzepatide
Dual GIP/GLP-1 receptor agonist
Same companion posture as semaglutide, with coaching cadence tuned to tirzepatide's longer escalation ladder — more months of support before a member reaches maintenance.
Omada Health Reviews Liraglutide
GLP-1 receptor agonist
Supported like any other GLP-1, with the coaching emphasis shifted toward daily-injection adherence rather than the escalation-window nausea that dominates the weekly agents.