Large employers are grappling with the high costs of GLP-1 medications

GLP-1 medications for weight loss are biting into large employers’ budgets, and in some cases coverage has become financially untenable, recent examples suggest.

Bank of America CEO Brian Moynihan recently said that the company is spending more than $250 million annually on GLP-1s, representing 13% of its total healthcare spending. BofA has no plans to drop coverage, though, as Moynihan cited both short- and long-term benefits for the workforce and the bank, which anticipates spending less on healthcare for obesity-related conditions, such as cardiovascular events.

Starbucks, on the other hand, recently stopped covering GLP-1s for weight loss, Business Insider reported on Aug. 7. The coffee chain isn’t the only high-profile employer to do so—PwC told US staff they would no longer cover the medications for weight loss back in the spring, according to the Financial Times. Though neither company disclosed their GLP-1 spend, a recent survey indicates that the costs of this drug category are prompting some large employers to reconsider coverage. Nearly 8 in 10 employers surveyed by the Business Group on Health, whose members include large organizations, said GLP-1s were driving an increase in their company’s health costs, and 10% say they likely wouldn’t continue coverage in 2027.

Such examples show how the rising popularity of GLP-1s are affecting decision-making around benefits, even as policymakers seek to lower the cost of the medications.

Total rewards leaders said GLP-1 coverage was weighing on their total health costs during a panel hosted by From Day 1, a media outlet focused on corporate values, back in June. (This reporter was a panelist.) Lloyds Banking Group recently launched a wellness program with the goal of reducing GLP-1 utilization, according to Monique Scroggins, VP of HR total rewards and operations. The company is encouraging employees to pursue other methods that may lead to weight loss, such as exercising during work breaks and eating healthy.

If costs don’t come down, she said the firm may stop covering GLP-1s for weight loss, and instead focus only on diabetes.

“We are seeing a small, small margin of change across the utilization for our benefits, and so we’re hoping to have more money allocated towards wellness as opposed to changing the plans,” she explained.

Where the GLP-1 market is headed. In recent months, members of the government and private sector have taken actions with an eye toward lowering the cost of GLP-1 medications in the US.

The White House inked deals with two major GLP-1 manufacturers, Eli Lilly and Novo Nordisk, in November. Those companies, which produce Wegovy and Ozempic, agreed to lower the list price of these medications in exchange for Medicare coverage for some patients.

At the time, experts told HR Brew they believed such actions could eventually lower the cost of the drugs overall, and in turn affect the employer-sponsored market. Both Novo and Lilly are making a push to incentivize employers to cover GLP-1s with programs that allow them to bypass pharmacy benefit managers (PBMs) and access the medications at the same price available on the direct-to-consumer market.

As more GLP-1 drugs come to market, prices should come down, Mitzi Wasik, executive director of the Academy of Managed Care Pharmacy foundation, predicted in a recent interview with Healthcare Brew.

“If there’s only one or two drugs on the market, you have no leverage, really,” Wasik said. The arrival of new GLP-1s, coupled with negotiations by the Trump administration and carved-out solutions designed to control costs, “will definitely drive down the price overall.”

Still, employers’ recent decisions to drop coverage indicates that prices might not be coming down fast enough.

Wasik cited a number of strategies employers are using to manage GLP-1 costs, including pairing them with diet and exercise programs, as well as instituting prior authorization requirements to show they’re continuing to stay engaged and committed to staying on the drugs.

“The patient has to feel accountable for their outcomes as well, because it’s not just a drug,” she said.

Maia Anderson contributed reporting.