REPORT: Non-diabetes GLP-1 prescriptions would double upcoming city employee health insurance rise

MANCHESTER, N.H. – City employees in Manchester may soon not be able to obtain prescriptions for GLP-1 medications for purposes other than diabetes, a trend seen throughout local governments in recent years.

GLP-1, short for glucagon-like peptide-1, is a type of medication based on the hormone of the same name that helps regulate blood sugar and appetite by stimulating insulin release and slowing stomach emptying. Originally designed as weight loss drugs due to their ability to decrease appetite, the drugs have become effective tools for individuals battling diabetes as well.

During the April 3 hearing of the Manchester Board of Mayor and Aldermen Committee on Human Resources, City of Manchester Human Resources Director Victoria Prestejohn reported that an additional $1.8 million is expected for the city's employee health plan in Fiscal Year 2027. If GLP-1 prescriptions for non-diabetes purposes were continued, she noted that would add an additional $1.7 million on its own on top of the $1.7 million.

In 2025, the Manchester School District stopped providing GLP-1 drugs to its employees for comparable reasons.

In a letter to the board, Prestejohn said incoming pill versions of GLP-1 drugs may change the cost of GLP-1 non-diabetes prescriptions in the future and that the RxSaveCard program could partially cover costs of the drug. However, she recommended putting a hold on non-diabetes prescription approval for now given the amount of the increase needed, with members of the committee not disagreeing with this assessment.

Although the city has never officially approved non-diabetes GLP-1 prescriptions for its employees, they were accidentally granted for a period in 2025 by Anthem.

Alderman At-Large Dan O'Neil requested information on beneficial aspects of GLP-1 medications to those using the drugs for weight loss purposes. Representatives of USI, one of the city's insurance providers said they would obtain this information, which they also indicated did have long-term cost savings of amounts not specified during the meeting.