How Employers Are Responding to GLP-1 Drug Costs

If you work in benefits, you've heard about GLP-1 drugs. Ozempic. Wegovy. Mounjaro. What started as diabetes medications have become the most talked-about drugs in years—because they work for weight loss, and everyone wants them.

For employers, this creates a problem. A big, expensive problem.

The Cost Reality

GLP-1 medications cost roughly $1,000-$1,500 per month per patient. For a drug that may need to be taken indefinitely to maintain results, the math gets alarming fast.

Even modest utilization can move the needle on total drug spend. And utilization is growing rapidly. Every month, more employees are asking about coverage. More prescriptions are being written. More claims are hitting the system.

How Employers Are Responding

We're seeing a range of approaches as employers try to balance cost control with employee demand.

Covering for diabetes only. Some employers are limiting coverage to FDA-approved indications for diabetes management. Weight loss use is excluded or requires exception review.

Adding prior authorization. Many employers are implementing or tightening prior auth requirements—documented BMI thresholds, failed attempts at other interventions, physician attestation of medical necessity.

Carving out to specialty. Some employers are moving GLP-1s to specialty pharmacy management with additional utilization controls and mandatory counseling programs.

Covering broadly. Other employers, particularly those competing for talent in tight labor markets, are covering GLP-1s for weight loss with minimal restrictions. They're betting that healthier employees mean lower long-term costs—or they're simply responding to employee demand.

Waiting and watching. A meaningful segment is still figuring out their position. They haven't made explicit policy decisions and are handling requests case by case.

The Hard Questions

There's no easy answer here. Employers are wrestling with real tradeoffs:

Is this a lifestyle drug or a medical treatment? The science increasingly says obesity is a disease. But historically, weight loss interventions haven't been covered the way other treatments are.

What's the long-term cost picture? If employees need these drugs indefinitely, that's a permanent cost increase. But if weight loss reduces diabetes, cardiovascular disease, and other conditions, there may be downstream savings.

What about fairness? If you cover GLP-1s for weight loss, what about other weight management approaches? What about employees who manage their weight through diet and exercise—are you creating inequity?

Can you afford not to cover it? In competitive hiring markets, benefits matter. If your competitors cover GLP-1s and you don't, does that affect your ability to attract and retain talent?

What We're Tracking

This is one of the most dynamic areas in benefits right now. Employer positions are evolving month to month as they see utilization data, hear from employees, and watch what peers are doing.

We're tracking coverage policies, utilization management approaches, and how different employer segments are responding. If you want to know what employers like yours are doing, we can help you find out.

This isn't going away. The question is how you'll respond.