Employer Co-Pays For GLP-1 Weight Loss Drugs To Rise If They’re Covered
The latest report on rising employer healthcare costs highlights the impact of GLP-1 weight loss drugs like Ozempic, Zepbound, and Wegovy on prescription spending. This trend is concerning for employee out-of-pocket costs, as seen in the 2026 Milliman Medical Index report. The annual cost of insuring a family of four has exceeded $35,000, with a 7.2% increase from 2025 to 2026. A significant portion of this cost, estimated at 58%, is attributed to employee contributions and out-of-pocket expenses, totaling around $15,000.
Pharmacy costs are identified as the fastest-growing component of healthcare expenses, with prescription drug costs accounting for 13% of total family health spending in 2026. GLP-1 drugs for diabetes and weight-loss management are cited as key contributors to rising pharmacy spend and are projected to continue impacting employer costs in the coming year. As a result, companies are likely to shift more costs onto their employees through increased premiums, co-payments, or deductibles.
Employers have been reevaluating their coverage of GLP-1 drugs, considering restrictions or discontinuation to mitigate rising healthcare expenses. The Business Group on Health suggests that employers may implement utilization management, require prescriptions from specific providers, or mandate participation in weight management programs to control costs associated with these medications. A recent analysis also indicates that some employers may opt to discontinue coverage for GLP-1 drugs for weight management in 2027.
Specialty drug costs, including GLP-1 medications, pose a significant challenge for health plans and employers in managing overall healthcare expenses. A survey conducted at the Asembia ASX26 summit revealed that 43% of health plans prioritize managing specialty drug costs over the total cost of care. This underscores the need for payers to develop effective coverage strategies, integrate pharmacy and medical benefits, and reassess traditional arrangements to address the increasing financial burden of specialty medications.
In conclusion, the rising costs associated with GLP-1 weight loss drugs are reshaping employer healthcare spending and necessitating strategic measures to contain expenses. Employers and health plans must collaborate on innovative solutions to effectively manage pharmacy costs, ensure sustainable financial models, and prioritize the overall well-being of their members.
