How are GLP-1 drugs affecting health plan costs?

Short answer: GLP-1 medications (such as semaglutide) are among the fastest-growing costs in employer drug plans. In 2025 they made up more than 10% of all prescription-drug claims in employer plans, with list prices over $1,000 a month before rebates. Employers are deciding whether to cover them for weight loss and, if so, how to manage use.

GLP-1 drugs, first used for diabetes and now widely prescribed for weight loss, have become a major cost driver. A 2025 survey by the International Foundation of Employee Benefit Plans found that GLP-1s used for weight loss made up more than 10% of all prescription-drug claims in employer health plans, and list prices run over $1,000 per month before rebates. Demand is broad across the workforce, and some employers have seen GLP-1 spending climb sharply year over year.

The central employer decision is coverage scope: cover GLP-1s only for diabetes, or also for weight loss? In 2025, about 19% of firms with 200 or more workers, and roughly 43% of those with 5,000 or more, covered them for weight loss. Many plans that do add guardrails such as prior authorization, step therapy, body-mass-index thresholds, and pairing the drug with a lifestyle program, to control cost while preserving access for those who benefit most.

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