What Does the Data Show on GLP-1 Prescribe Rates, Coverage, Costs?

Glucagon-like peptide-1 (GLP-1) medications are more top-of-mind than ever this year for employees — and they’re looking to their employers to help pay for them.

Developed first to treat diabetes but quickly distinguished for their weight-loss outcomes, the interest in (and popularity of) GLP-1 drugs shows no sign of slowing down today as availability expands and more people — whether it’s a celebrity on the big screen or your neighbor down the street — noticeably shed pounds after using them, said Julie Stich, the vice president of content at the International Foundation of Employee Benefit Plans (IFEBP), an education, research and networking organization.

The use of this medication class for weight loss indeed has skyrocketed. The 2% of adults now taking GLP-1s specifically to treat an overweight or obesity diagnosis represents a 587% increase over the last five years, according to nonprofit research and resources organization FAIR Health.

In the same time span, the percentage of adult patients with an overweight or obesity diagnosis has increased from 10.4% to 15.7% — although FAIR Health noted that many more do not receive a medical diagnosis; the U.S. Centers for Disease Control and Prevention (CDC) has estimated more than 40% of American adults have obesity.

By contrast, employer coverage of GLP-1s for weight loss saw just a slight uptick this year — with slower growth in coverage compared to previous jumps, according to several reports. For instance, an IFEBP survey of U.S. employers with corporate health plans found:

• 36% offer coverage for both diabetes and weight loss, compared to 34% in 2024 — and just 26% in 2023.
• Similarly, 55% cover GLP-1s for diabetes only, compared to 57% in 2024 — and 49% in 2023.

Consulting firm WTW found a similarly small increase in 2025 coverage in a recent pulse survey. While the larger employers included in the survey (with an average of about 13,000 covered employees) cover GLP-1s for weight loss at higher rates — 69% in 2025 — that number represents an increase of just 1% from the year before.

“There’s a lack of significant movement in [high GLP-1] prices, so I don’t anticipate seeing a lot of change in coverage,” said Cody Midlam, the director of WTW’s Pharmacy Community. “It really comes down to cost. Employers understand the potential these drugs offer, they understand the value, but they just have to take into account the budgetary considerations.”

Access bonus Workspan Daily Plus+ articles on this subject:

• Pay Today, Save Tomorrow? The Potential ROI for Covering GLP-1s
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A Costly Solution

Out-of-pocket costs for GLP-1s currently average about $1,000 or more a month before taking into account insurance coverage or discounts — prompting workers to turn to their employers for help with coverage.

“More than half of insured U.S. adults who’ve used GLP-1s report difficulty affording the medication,” said Farheen Dam, the head of North America health solutions at risk management and HR consulting firm Aon. “Employers have a real opportunity to step in, offer these treatments affordably and with dignity, and position themselves as employers of choice.”

While weighing the choice to cover GLP-1s, employer cost is a significant consideration, Midlam noted. The “employer freight,” measured at a per-member-per-month (PMPM) rate across all covered employees (not just those utilizing the drugs), has steadily increased — from $11 PMPM in 2023 to more than $24 PMPM in 2024, and that up from about $1.50 PMPM in 2019.

GLP-1 drug costs represented an average of 10.5% of total annual insurance claims in 2024, up from 8.9% in 2023 and 6.9% in 2022, IFEBP found. Some reports were higher still, with 27% of employers finding GLP-1 weight loss coverage encompassed more than 15% of their annual claims in 2024, compared to 15% of employers who said the same in 2023.

Spiking costs — paired with increasing demand and indications that GLP-1s need to be taken for a good amount of time to be effective — are creating an onerous challenge for many employers. Some have pulled back or canceled their coverage of the drugs after initially offering it. Among the businesses surveyed by WTW this year, 30% said they’re at least somewhat likely to remove coverage in the next few years if prices remain where they are, with only 15% of those without coverage considering adding it at current prices.

Total Rewards Takeaways

So, what does this mean for organizations and their total rewards professionals, with open enrollment season on the horizon and a greater preponderance of employees interested in access to GLP-1s?

The health status and needs of each individual workforce should be taken into account when considering coverage, as well as the potential side effects associated with GLP-1s, Stich said.

It’s common to establish cost-control mechanisms when covering a certain treatment or medication. IFEBP’s survey found utilization management techniques, largely prior authorization, to be most utilized (by 78% of organizations). That was followed by eligibility requirements such as certain diagnoses or a minimum body mass index (set in place by 68% of employers), with step therapy — requiring employees to try other treatments first — a distant third at 14%.

Some employers are implementing weight management wraparound programs to boost employees’ long-term adherence to GLP-1s and support longer-lasting results — with the idea that the treatment is more effective when it’s not offered in a silo.

“If employers are also offering other benefits to encourage a healthy lifestyle and promote prevention, they may want to think of GLP-1s as part of a whole,” Stich said.

Aon found only one-fifth of employers have a lifestyle or behavior management program to support employees taking GLP-1s. Offering assistance benefits and programs — such as coaching, nutrition guidance, fitness resources and mental health tools, all of which Aon is exploring — will become more key, Dam said.

“With more people staying on therapy longer, new indications on the rise and a strong pipeline ahead, employers need to take a sharper, more strategic approach to managing this drug class,” she said.

In some cases, employers can access discounts or rebates to lower the cost of GLP-1s, but Midlam noted implementing certain utilization management strategies could disqualify businesses from rebates. Because of the various barriers to affordable coverage, some businesses are instead considering pointing employees toward the “cash-pay” option — accessing a significantly reduced price tag by paying out of pocket rather than going through insurance.

“But there is the challenge that [such a strategy] introduces equity concerns, as the price remains high even for the cash-pay option,” Midlam said. “We’re getting a lot of employers who are exploring capabilities to subsidize cash-pay offerings in some way … to help members meet them in the middle.”

Research supporting potential long-term employer cost savings from health improvements stemming from GLP-1 use is nascent but promising, Aon has found — and that’s something for employers to keep in mind, too.

“Total rewards professionals are constantly weighing how each dollar is spent, recognizing that every investment in healthcare must be evaluated for both its immediate cost and its long-term impact on employee health and organizational outcomes,” Dam said. “Achieving the right balance between cost and long-term health outcomes requires a holistic view of the benefits program — grounded in data and tailored to the unique needs of the workforce.”

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