Some employers hold off on expanding GLP-1 coverage, for now

Concerns about the rising cost of healthcare seem to be everywhere these days, from the corridors of Capitol Hill to CEOs’ corner offices.

HR leaders are particularly attuned to how this trend is affecting their workforces and overall benefits strategy. Recent surveys show employers expect health costs to rise by upwards of 9% next year, with many respondents pointing to GLP-1 drugs for weight loss as a top culprit. These medications carry a high list price—around $1,000 a month—but hold promise for effectively treating conditions ranging from obesity to heart disease.

A recent poll conducted among clients of the consulting firm Mercer shows organizations are holding off on plans to cover GLP-1s for weight loss in the future, if they aren’t already doing so.

Some employers sit tight on GLP-1s. Mercer surveyed around 200 clients who attended a Nov. 13 webinar on regulatory and policy updates for US employers and employees. In response to a question directed to respondents whose organizations don’t already cover GLP-1 medications for weight loss, 70% said they weren’t considering adding coverage, or a health reimbursement arrangement (HRA), in the future. Employers sometimes offer HRAs to help workers purchase drugs through the direct-to-consumer market.

Nearly twenty-one percent of respondents said they were considering adding GLP-1 coverage to their medical or Rx plan in the next few years, while 5.5% said they planned to do so in 2026.

The results suggest employers are sitting tight on adding GLP-1 coverage for weight loss to their medical plans, even as the Trump administration seeks to lower the cost of the drugs for Medicare and Medicaid beneficiaries, as well as Americans without insurance.

It’s not yet clear whether workers on employer-sponsored health insurance will benefit from recent agreements with two GLP-1 manufacturers to offer their drugs at lower prices. Employers’ hesitancy to cover GLP-1s “primarily comes down to cost,” said Katharine Marshall, a principal with Mercer’s law and policy group.

“I would like to think that the agreements made with the White House...would put some pressure on those pharmaceutical companies to provide similar pricing for commercial plans, but I think we’re going to have to wait and see,” she said.

GLP-1s were first approved to treat diabetes in 2005, and most employers cover them for this reason. Weight loss is a more recent indication, and coverage varies by employer size, surveys suggest. Nineteen percent of firms with 200 or more employees cover GLP-1s for weight loss in their largest health plan, according to KFF’s most recent benefits survey, but coverage is more prevalent among firms with 5,000 or more workers (43%).