The obesity-drug value chain: from employer coverage to DTC channels to Medicare Patient demand routes through access channels; volume and margin land with the brand owners while retailers take a thin cut and independents drain. patients GLP-1 access employer coverage dropping DTC retail programs Costco · Sesame Walmart CVS NovoCare Amazon Pharmacy cash prices · fills access void Medicare bridge reported · senior access brand owners LLY · Novo own the molecule high-margin volume accretes to the maker retailer channel thin cut membership fee thin retail cut independents lose volume fragmentation risk brand owner margin retailer thin cut independents drain