Express Scripts to drop coverage of weight loss drugs for A-B employees

ST. LOUIS — Express Scripts will stop covering weight loss drugs for workers at Anheuser-Busch, one of the region's biggest employers, next month.

In a letter to an Anheuser-Busch employee dated July 2025 and obtained by the Post-Dispatch, Express Scripts and its parent company, Evernorth Health Services, suggested its existing coverage of the popular drugs had been a mistake.

"Due to an oversight, medications indicated for the treatment of weight loss have been covered by your plan," the letter from Express Scripts Pharmacy Benefit Services states. The letter goes on to say the "oversight" would be corrected by Aug. 1 and "any claim submitted for a weight-loss medication on or after that date will not be covered by your prescription plan and will hard reject."

The A-B employee who received the letter, and who asked to remain anonymous, said the insurance plan has covered workers' weight-loss medication for several years.

A spokeswoman for Express Scripts and Evernorth said there were no changes beyond that health insurance plan and referred further questions to Anheuser-Busch. Spokespeople for the beverage giant did not respond to requests for comment.

As of 2019, Anheuser-Busch employed about 3,000 people at its brewery and North American headquarters in St. Louis and about 19,000 across the U.S. Unionized brewery employees are covered by a different health plan, according to the employee who received the letter.

Fading Clydesdales sign comes down, making way for a new one at Anheuser-Busch

Erich Monk, left, and Tracy Burk of Piros Signs have a look at the Clydesdales sign before dismantling it on Tuesday, Jan. 31, 2023. The sign, originally installed on the Anheuser-Busch St. Louis Brewery building in November 1968, was replaced with a new mural of identical size painted by artist Phil Jarvis.

Weight loss drugs have boomed in recent years since the introduction of blockbuster diabetes drug Ozempic. Since then, the soaring cost of such drug coverage has become a major concern for employers, and more than half plan to shift more of the burden for health benefits to employees as costs for such medications rise, according to a survey released last week by consulting firm Mercer. While employers long have covered such drugs to treat diabetes, fewer than half of employers cover the drugs when used to treat obesity, according to Mercer.

“While the trend over the past couple of years has been to add coverage for (drugs) approved for weight-loss, some employers facing large cost increases in 2026 may feel this coverage is out of reach,” Alysha Fluno, Mercer’s pharmacy innovation leader said in a statement. “Employers are weighing the immediate costs of covering these drugs against the potential for generating savings down the road once their workforce’s health improves.”

It was unclear whether Evernorth's decision was to correct a newly uncovered error in coverage or whether it is in response to action by A-B to scale back its health coverage. It remained unknown whether A-B, under financial pressure amid slumping sales, would fight the new interpretation or move to reinstate coverage of weight-loss drugs for its workforce.

Take a look back at June 2025

Post-Dispatch photographers capture tens of thousands of images every year. See some of their best work that was either taken in June 2025 in this video. Edited by Jenna Jones.

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