Photo Illustration of the new Wegovy semaglutide tablets with injectable prescription weight loss medicines, Ozempic, Victoza and Wegovy. Its a prescription medicine used with a reduced calorie diet and physical activity. (Photo by: Michael Siluk/UCG/Universal Images Group via Getty Images)
UCG/Universal Images Group via Getty Images
More employers and health plans are balking at paying for costly GLP-1 drugs like Ozempic, Zepbound and Wegovy for weight loss and the treatment of obesity, according to a new report.
A survey of benefits executives at more than 235 employers, health plans and unions showed nearly half, or 49%, or firms who do not currently cover GLP-1s for obesity would “not do so at any price,” Pharmaceutical Strategies Group said in a statement accompanying its 2026 Trends in Drug Benefits Report released Tuesday. Meanwhile, 9 in 10 of the respondents from plans with a median of 14,000 enrollees, said they were “moderately” or “very concerned” about the affordability of GLP-1 therapies for the plan.
“As drug costs climb, payers are under pressure to re-evaluate benefit design and cost management strategies,” said Morgan Lee, Vice President of Research and Marketing at PSG. “The debate around GLP-1 coverage is a prime example of the balancing act benefits leaders face as they navigate skyrocketing demand, affordability concerns, and uncertainty around long-term patient outcomes.”
Just last week, Cigna confirmed it was no longer covering GLP-1 weight loss drugs for its own employees effective July 1.
The change, however, doesn’t impact coverage of the prescriptions for the treatment of type-2 diabetes. Cigna is acting like about 95 percent of employers that the PSG report says cover GLP-1 drugs for those with type-2 diabetes.
“We regularly review our health benefits to ensure they remain sustainable, accessible, and aligned with the unique needs of our workforce,” Cigna said in a statement about its GLP-1 coverage move. “As availability has increased and new options have emerged, we’ve made the decision to end our plan’s coverage for GLP-1s for weight loss. We remain committed to supporting our employees’ health through a range of weight management programs and resources.”
Increasingly, employers are guiding their workers to cash-paying market for GLP-1 drugs where prices have fallen in the last year. It’s not uncommon for oral pills or injectable dosages to be purchased for about $150 a month.
But it’s not just cost that is figuring into employer and health plan decisions not to cover GLP-1 drugs.
The PSG report said “high discontinuation rates are now playing a major role in coverage decisions, as nearly two-thirds of patients without type 2 diabetes who take GLP-1s discontinue treatment within one year.” In addition, 72% of those surveyed indicated that “discontinuation rates and weight regain were at least moderately influential in their GLP-1 coverage decisions.”
“Discontinuation rates are very high and employers want to know if this will actually provide a return on their investment if they (workers) aren’t taking them long-term,” Lee said in an interview.