Sacra estimates Virta Health hit $158M in annualized revenue at the end of August 2025, up from $107.5M at the end of 2024 and up more than 80% YoY.

Revenue is primarily generated through B2B2C partnerships with self-insured employers, health plans, and government organizations. Virta operates with approximately 550 B2B customers covering 12M+ U.S. lives as of 2025, achieving an average revenue per customer of $290K+ - roughly double that of competitor Omada Health ($158K). The company reports gross margins of approximately 60%, driven in part by AI automation of patient interactions.

Virta's revenue mix has evolved significantly since 2021, with diabetes reversal revenue decreasing from 78% to 54% of total revenue in 2024, while obesity revenue has grown from 10% to 27%. The remaining revenue comes from diabetes management (14%) and platform fees (5%). This shift reflects the company's expansion into Sustainable Weight Loss, which now accounts for 45% of new enrollments.

The company's pricing model is value-based, with fees at risk tied to patient outcomes. Their diabetes reversal program commands premium pricing ($2,808 per member year 1, $2,388 subsequent years) with strong retention rates (90% year 1, 74% year 2). Their Sustainable Weight Loss program and diabetes management program serve as additional revenue streams with lower price points but larger addressable markets. Virta now offers industry-first cost guarantees including 0% YoY growth in GLP-1 utilization with guaranteed weight loss outcomes, and 1:1 claims-based ROI for nutrition-only programs.

Virta Health was last valued at $2 billion following its Series E funding round in April 2021, led by Tiger Global. The company has raised a total of $376.5 million across 7 funding rounds since its founding in 2014.

Based on Virta's estimated 2021 revenue of $35M, this valued the company at approximately 57x LTM revenue. Key investors include Tiger Global, Sequoia Capital Global Equities, and Caffeinated Capital. The company's Series D round was led by Sequoia Capital Global Equities in December 2020.

Virta Health was founded in 2014 by Sami Inkinen, who previously co-founded Trulia, after he was diagnosed as pre-diabetic despite being a competitive athlete. Inkinen discovered decades-old research suggesting the ketogenic diet could reverse diabetes and founded Virta to productize this approach through technology-enabled care delivery.

The product combines connected devices, continuous remote monitoring, and personalized coaching to help patients implement and maintain a ketogenic diet. When a patient enrolls, they receive a starter kit containing a connected glucose meter, ketone meter, and scale. Patients check in with their Virta health coach 2-4 times daily through the Virta app, tracking their food intake and symptoms while receiving guidance on their personalized meal plan. Behind the scenes, Virta physicians monitor the data from connected devices to make medication adjustments, particularly crucial in the first 10 weeks as blood sugar levels normalize and insulin doses often need reduction. Virta has deployed AI and machine learning since 2017 to automate aspects of patient interactions while maintaining human oversight for clinical decision-making.

Virta's approach differs from traditional diabetes management apps by focusing on reversal rather than helping patients peacefully coexist with their condition. The program requires intensive monitoring due to the risks associated with suddenly reducing carbohydrate intake to less than 50 grams per day while on insulin, which can cause dangerous blood sugar fluctuations. To maintain high success rates, Virta carefully screens potential patients, rejecting those with c-peptide levels below their cutoff or certain comorbidities.

The company has expanded beyond nutrition-only interventions to include GLP-1 prescribing capabilities within its Sustainable Weight Loss offering. The company's "Responsible Prescribing" approach results in less than 25% of Sustainable Weight Loss members using GLP-1 medications, with clinical results showing >50% prevention of ongoing GLP-1 use among members who were already on GLP-1s when they enrolled, and approximately 5% average weight loss in 90 days regardless of medication use. The company has also broadened its offering to include obesity treatment and prediabetes reversal programs, leveraging the same infrastructure of continuous monitoring and coaching.

Virta was selected by CMS as an early adopter in the Health Tech Ecosystem Initiative, participating in the Diabetes & Obesity Prevention and Management pillar with expected progress milestones by early 2026.

Virta Health operates a B2B2C virtual care platform focused on reversing type 2 diabetes and obesity through intensive nutritional therapy and continuous remote monitoring.

The company primarily generates revenue through contracts with self-insured employers, health plans, and government organizations, who offer Virta's program as a covered benefit to their members.

Virta's pricing model is built around outcomes-based contracts, with their diabetes reversal program priced at $2,808 per patient for year one and $2,388 for subsequent years. Their Sustainable Weight Loss program is priced at $900 per year, while their diabetes management program costs $950 per year. Virta introduced industry-first cost guarantees in 2025, including a 0% YoY growth guarantee in GLP-1 utilization (measured by prescription volume) with guaranteed weight loss outcomes, and a 1:1 claims-based ROI guarantee for nutrition-only Sustainable Weight Loss or Diabetes Reversal programs, promising at least dollar-for-dollar savings versus fees paid.

The company operates at approximately 60% gross margins, enabled in part by AI automation of patient interactions while maintaining human oversight for clinical decisions. The intensive monitoring model requires significant upfront investment in connected devices and health coaching infrastructure, but the outcomes-based pricing aligns incentives with payers focused on reducing long-term healthcare costs.

The company's growth strategy leverages both expansion within existing accounts and new customer acquisition. With an average of only 180 patients enrolled per customer (roughly 5-10% of eligible population), Virta has significant headroom to grow revenue by increasing penetration within their current customer base. Their Sustainable Weight Loss program, which now includes selective GLP-1 prescribing capabilities, has become a major growth driver - obesity now accounts for 45% of new enrollments, up from 20% in 2021.

Virta Health operates in a market that includes virtual care providers focused on chronic metabolic conditions, particularly type 2 diabetes and obesity. The competitive landscape can be divided into three main categories: digital health platforms, traditional diabetes management providers, and emerging GLP-1 focused solutions.

The primary competitors in this space are Omada Health and Livongo (acquired by Teladoc for $18.5B in 2020). Omada Health generates approximately $300M in annual revenue serving 300,000 patients across 1,900 customers, with an average revenue per customer of $158K.

Their platform combines connected devices with health coaching, focusing on diabetes prevention and management rather than reversal. Livongo, through Teladoc's network of 3,000+ telehealth PCPs, leverages existing relationships with 600+ employers and health plans to distribute their diabetes management solution.

Both companies have expanded horizontally into mental health and musculoskeletal care through acquisitions, while maintaining lower-intensity protocols built around calorie counting and balanced diets.

This segment includes established players like DarioHealth, Glooko, Perry Health, and Verily (Onduo). These companies primarily focus on medication adherence and lifestyle modifications within existing treatment paradigms.

They typically generate revenue through traditional insurance reimbursement and often partner with pharmacy benefits managers (PBMs) for distribution. For example, Omada is the preferred partner for Evernorth, giving them access to 180 million customers through the PBM channel.

A new category of competitors is emerging around GLP-1 medications like Wegovy and Ozempic. Companies in this space are developing managed programs that combine GLP-1 prescriptions with lifestyle interventions.

Insurance companies like BCBS Michigan and North Carolina's State Health Plan now require GLP-1 patients to participate in these managed programs. This has created opportunities for both traditional players and new entrants to develop GLP-1-specific offerings, though the high cost of these medications ($3,000 annually versus $900 for traditional management programs) has led some payers to seek alternative solutions.

Virta Health has tailwinds from the rising costs of GLP-1 medications and growing employer concerns about healthcare spending, and has the opportunity to expand into adjacent metabolic conditions like cardiovascular disease and non-alcoholic fatty liver disease (NAFLD).

The surging popularity of GLP-1 drugs like Ozempic and Wegovy is driving up employer healthcare costs, with spending on these medications expected to reach $25-30B annually by 2025. This creates an urgent need for cost-effective alternatives. Virta's Sustainable Weight Loss program at $900/year offers significant savings compared to $3,000+ annually for GLP-1s, with the company reporting that one Fortune 100 client reduced GLP-1 growth by 49% in 6 months through optimized prescribing and nutrition-first alternatives.

Virta research found that 36% of 500 surveyed U.S. adults who stopped GLP-1s for weight loss reported weight regain, creating demand for post-GLP-1 support services. Patients who tapered off GLP-1s under medical guidance were 8x more likely to continue losing weight (56%) compared to those who quit abruptly (7%). More insurers are now requiring GLP-1 patients to enroll in managed programs like Virta's, positioning the company as both an alternative and a medically-guided "off-ramp" focused on sustainable lifestyle changes.

Virta was selected by CMS as an early adopter in the Health Tech Ecosystem Initiative, participating in the Diabetes & Obesity Prevention and Management pillar. The company is targeting meaningful progress milestones by early 2026, which could open access to Medicare and Medicaid populations. With government payers representing a significant portion of the 37 million Americans with diabetes and 42% of U.S. adults with obesity, CMS partnerships could substantially expand Virta's addressable market beyond commercial employers and health plans.

Virta's ketogenic protocol has shown promise beyond diabetes reversal, creating opportunities to expand into other metabolic conditions that respond to carbohydrate restriction. Cardiovascular disease and NAFLD represent natural expansion targets given their close relationship with insulin resistance and obesity. The global NAFLD treatment market alone is projected to reach $21B by 2025. Virta's existing infrastructure for continuous remote monitoring and medication management could be adapted to serve these conditions, allowing efficient scaling to new patient populations while maintaining their outcomes-based pricing model.

With only 5-10% enrollment among eligible employees at current customers, Virta has significant headroom to grow within its existing base of 550+ enterprise clients covering 12M+ U.S. lives. The company's shift from primarily serving diabetes patients (78% of revenue in 2021) to a more balanced revenue mix including obesity (27% of revenue in 2024) demonstrates their ability to expand scope while maintaining strong clinical outcomes. As Virta proves the effectiveness of their model across multiple conditions, they can leverage their B2B relationships and outcomes-based pricing to capture a larger share of employers' healthcare spending.

Three critical risks facing Virta Health:

1. Narrow Patient Selection: Virta's strict enrollment criteria (rejecting patients with c-peptide levels below their cutoff) and intensive monitoring requirements (2-4 daily check-ins) significantly limit their total addressable market.

While this selective approach helps maintain high success rates, it could hamper growth as they pursue their goal of treating 100 million patients. The company may face pressure to relax these standards to achieve scale, potentially compromising their impressive clinical outcomes that differentiate them from competitors.

2. GLP-1 Market Dynamics: While Virta positions itself as both an alternative and complement to GLP-1s, the explosive growth of these medications could reshape patient expectations.

As more insurers require managed programs for GLP-1 prescriptions, Virta risks becoming primarily an "off-ramp" program rather than a first-line treatment. This shift could reduce their pricing power and force them to compete more directly with traditional diabetes management programs from Omada and Livongo.

3. Revenue Mix Deterioration: Virta's revenue mix is rapidly shifting from high-margin diabetes reversal (78% in 2021 to 54% in 2024) toward lower-margin obesity treatment (10% to 27%).

This trend threatens their unit economics, as obesity patients have lower retention rates (85% vs 90% year 1) and significantly lower pricing ($900/year vs $2,808). While obesity represents a larger market, it's also more competitive and could compress margins over time.