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Employers Tighten Requirements for GLP-1 Weight-Loss Drug Coverage

Created at 10 Jun · 11:08 PM2 sources↑ Market-relevant2 events
IN SHORT

Some U.S. employers are planning to discontinue coverage for GLP-1 weight-loss drugs in 2027 due to increasing demand and costs. New requirements like weigh-ins and health coaching are being implemented, while some companies are ceasing coverage altogether.

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Key Numbers

10%employers planning to drop GLP-1 coverage in 2027
5%large employers planning to drop GLP-1 coverage in 2027
500employees for large employers defined by Mercer
44%companies with over 500 employees covering GLP-1s for obesity
67%large employers covering GLP-1s in 2026
$149monthly starting price for newer GLP-1 pills

Who's Involved

Employers
increasingly tightening coverage requirements for GLP-1 weight-loss drugs
Business Group on Health
policy research group for large employers surveyed on GLP-1 coverage plans
Mercer
benefits consultancy that surveyed large employers on GLP-1 coverage
Cigna
health insurer that ceased GLP-1 coverage for its own employees
Novo Nordisk
drugmaker of Wegovy and Foundayo GLP-1 medications
Eli Lilly
drugmaker of Zepbound and Foundayo GLP-1 medications
Lauren Remspecher
director at Purchaser Business Group on Health commenting on employer costs
Louis Zollo
pharmacy practice leader at healthcare consultancy Segal on patient population growth
Aon
consultancy observing shifts to oral GLP-1 versions and expecting coverage decrease
Dan Mendelson
CEO of Morgan Health on aggregate cost drivers for employers

↳ Why This Matters

The increasing cost and demand for GLP-1 weight-loss drugs are prompting employers to re-evaluate and potentially reduce coverage, impacting employee access to these treatments and highlighting the ongoing challenge of managing expensive medications within corporate health plans.

Key facts

  • Some U.S. employers plan to drop coverage for GLP-1 weight-loss drugs in 2027.
  • New requirements such as weigh-ins, app tracking, and health coaching are being implemented for GLP-1 coverage.
  • About 10% of employers currently covering GLP-1s for weight loss intend to discontinue coverage in 2027.
  • A Mercer survey found 5% of large employers plan to drop coverage for these drugs in 2027.
  • Health insurer Cigna stopped covering these treatments for its own employees starting July.

Some U.S. employers are planning to discontinue coverage for GLP-1 weight-loss drugs in 2027 as the number of people taking these medications increases. This trend is occurring despite lower prices for newer oral versions of drugs like Novo Nordisk's Wegovy and Eli Lilly's Zepbound and Foundayo. Employers are implementing stricter requirements for coverage, including mandatory weigh-ins, app tracking, and health coaching. Some companies are also discontinuing coverage altogether.

Surveys indicate that approximately 10% of employers currently covering GLP-1s for weight loss intend to drop them in 2027, with a separate consultancy reporting 5% of large employers planning the same. While newer oral pills are available at lower monthly costs, employers are concerned about not achieving the same savings as direct cash purchases, especially as the patient population grows and individuals remain on treatment long-term. This increased demand and broader eligibility are contributing to sustained high costs for employers, making GLP-1s a significant cost driver.

Frequently asked questions

GLP-1 drugs mimic a hormone to help regulate blood sugar and appetite, and are increasingly used for weight loss in addition to type 2 diabetes management.

Employers are concerned about the rising costs associated with the increasing demand and long-term use of these medications, despite some price reductions for newer formulations.

Employers are increasingly mandating weigh-ins, the use of health-tracking apps, and participation in health coaching programs for employees seeking coverage for GLP-1 drugs.

Yes, newer oral GLP-1 pills are available directly from drugmakers' websites at discounted prices, offering an alternative for individuals who may lose employer coverage.

What Happens Next

01Employers will continue to monitor GLP-1 utilization and costs.
02Further changes to coverage policies for GLP-1 drugs are expected in subsequent years.

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Cadence

How It Developed

Employers are increasingly requiring weigh-ins, app tracking, and health coaching for GLP-1 coverage.
Some employers are discontinuing coverage for GLP-1 weight-loss drugs.
About 10% of employers who cover GLP-1 drugs for weight loss plan to drop them in 2027.
A separate survey indicated 5% of large employers plan to drop coverage of the drugs in 2027.
% of companies with over 500 employees currently cover GLP-1 drugs for obesity.
Health insurer Cigna ceased coverage of weight-loss treatments for its own employees effective July.
Newer oral GLP-1 pills are available at discounted prices through drugmakers' websites.
Employers are concerned they are not seeing savings from pharmacy benefit managers compared to direct purchases.

Sources

T1
More employers are requiring weigh-ins, app tracking and health coaching before covering GLP-1s for losing weight—or dropping coverage altogether. 🔗 https://t.co/Dbp54Bjuo9 https://t.co/4GyGwaOg7k@WSJ via PiQSuite
T1
Some US employers to drop coverage of GLP-1 obesity drugs in 2027 as use increasesReuters via PiQSuite

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