GLP-1 drugs for obesity remain top of mind for employers actively evaluating how best to address the rising cost of these medications. Our Pulse Survey earlier this month found that two-thirds of clients (66%) currently cover GLP-1s for obesity, and most intend to continue doing so. Few clients that do not cover GLP-1 drugs for obesity are considering adding them. The pulse survey included 294 clients with a total of over 2.8 million plan members.
This finding is consistent with our 2025 Best Practices in Healthcare Survey, where 57% of employer respondents indicated coverage of GLP-1 medications for obesity.
Managing rising costs while preserving coverage
Even those employers covering GLP-1 drugs for obesity continue to weigh the rising costs carefully. While 70% indicate they intend to maintain coverage, 12% report being likely or very likely to discontinue, with an additional 18% indicating they are somewhat likely to do so.
Exploring alternative channels with caution
Few of those who do not cover GLP-1 drugs for obesity now intend to add such coverage. None reported that they were likely or very likely to add such coverage. One percent said they were somewhat likely to cover through the prescription plan, 6% said they were somewhat likely to add coverage through the direct to consumer (DTC) model, and 8% said they were somewhat likely to add via pharmaceutical company direct to employer (DTE) programs. Employers showed modest interest in procuring GLP-1 obesity medications through alternative distribution. When asked about redirecting coverage away from the traditional PBM model, 14% of employers say they are likely or very likely to redirect coverage to a DTC channel by January 1, 2027, while 37% are somewhat likely and 49% are not likely. Appetite for DTE models is smaller still, with only 7% saying they are likely or very likely to redirect coverage, 21% somewhat likely, and 72% not likely. These findings indicate that employers are exploring channel flexibility but remain cautious about making decisive shifts.
Clinical guardrails emerge as a clear priority
Where we see strong alignment among employers is in the importance of financial and clinical guardrails. Notably, 74% are considering or already using a clinical wrap to support appropriate utilization, engagement and outcomes. Commonly cited clinical partners include Vida, Virta, Omada, Calibrate, CVS and Form, underscoring a consistent preference for pairing GLP‑1 access with structured clinical oversight. Among those using or considering DTC or DTE arrangements, 92% report that they would subsidize the cost of the drug for members rather than shifting the full financial burden.
Taken together, our survey results point to a market characterized more by incremental adjustment than abrupt change. While employers remain focused on cost containment and are actively evaluating alternative channels and management approaches, most are not planning to eliminate GLP‑1 coverage in the near term. Instead, the prevailing strategy balances affordability and member demand with longer-term cardiometabolic value through targeted subsidies and vendor management.
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