GLP-1 costs loom large for employers

WASHINGTON, D.C. – Nearly eight in 10 employers report that GLP-1s are driving an increase in their company’s health care costs, leaving many to consider some difficult choices in balancing costs and care, according to a survey released today by Business Group on Health.

While most employers cover GLP-1s for diabetes, 67% of surveyed employers currently cover GLP-1s for weight management, the survey found, with many employers relying on various strategies to ensure the appropriate use of GLP-1s for weight management. These strategies include validating clinical eligibility via objective biometric data, requiring participation in a weight management program to receive coverage, limiting prescribing to specific providers and excluding certain medications from the formulary.

For some, however, such requirements do not allay the cost pressures on employers’ health care budgets. Of those covering GLP-1s for weight management, only 72% said they were likely to continue that coverage in 2027, while 10% said they likely would not, according to the survey. Companies that do not cover GLP-1s for weight management today are unlikely to add coverage in the future.

“Our findings show the tremendous concern employers have regarding these medications from a cost and financial viability perspective,” said Ellen Kelsay, president and CEO of Business Group on Health. “Against the backdrop of anticipated double-digit health care cost increases,  fueled to a large degree by GLP-1s and overall prescription drug costs, companies cannot ignore the reality that GLP-1s have significant implications for health care budgets – and overall affordability.”

The survey, which examined coverage of GLP-1s specifically for weight management, was completed in February-March 2026 by 105 employer members of Business Group on Health. It also examined employee support programs and utilization management in the context of an expanding range of options available to workers.

GLP-1s, known by brand names such as Ozempic, Wegovy, Mounjaro or Zepbound, were originally developed to help regulate blood sugar in people with Type 2 diabetes. They also lead to substantial weight loss for people with obesity and show promise in helping to manage other conditions, such as cardiovascular disease, obstructive sleep apnea and substance use disorder.

Additional survey findings: 

• While more than half of employers that cover GLP-1s for weight management expect the expensive medications to yield significant clinical benefits, few have yet seen evidence (such as a reduction in obesity rates and fewer employees needing bariatric surgery) within their aggregated claims.
• Fully 87% of employers anticipate that the availability of an oral GLP-1 medication will result in higher demand for the drugs overall, and only 9% of employers anticipate a decrease in price.
• When it comes to how much employees pay for the medications, most employers (83%) use the same standard cost-share arrangement as they do for other medications. This approach far exceeds options such as using a special design or having no out-of-pocket costs.
• Nearly eight in 10 employers involve their executive leadership in GLP-1 coverage decisions.