GLP-1 Pills Are Here: What Does It Mean for Employers?

GLP-1 injectables have become a big topic — and a bigger decision point — for employers. While the medications, which were first approved for diabetes management before gaining attention for weight loss, have resulted in positive health outcomes for many employees, they also have been a costly consideration for HR and benefits leaders.

Now another variable enters into the equation for employers: GLP-1 pills. 

The oral version of Wegovy, the GLP-1 receptor agonist used for chronic weight management, was approved by the Food and Drug Administration late last year, while Foundayo, a GLP-1 receptor agonist pill from Eli Lilly, was approved this month. 

It’s a significant development in the weight loss pharmaceutical game, and one that might be a boon for many employees in making the drugs easier to use and understand, compared to weekly injections. But for employers the potential to significantly accelerate employer pharmacy spend. 

“What was previously a high-cost, but relatively contained category, could quickly become much more widely utilized,” said Ferrin Williams, chief pharmacy officer at Scripta Insights, a prescription drug platform, in Las Vegas. “That creates both opportunity and risk: on one hand, the potential for better health outcomes and improved productivity, and on the other, the very real possibility of rapid cost expansion if it’s not managed thoughtfully.”

Related Article: How GLP-1 Drugs Are Reshaping Employee Wellness 

More Utilization

The biggest impact for workplaces will likely be increased utilization of the therapies. GLP-1 injectable medications were already growing significantly in employee interest and use. Now GLP-1 pills will likely expand the population of people who are both eligible and willing to pursue treatment beyond today’s injectable users, Williams said. “Those who opted out of injections in the past may now reconsider using GLP-1 knowing pills are an option,” she said. 

Nick Conway, president of Rx solutions at NFP, a New York City-based global benefits consultant and insurance brokerage firm, agreed.

“For those who weren’t comfortable with weekly injections, a once-daily pill is much easier to use and understand,” he said. “These medications are also easier to manufacture and distribute, which will likely lead to an increase in access and supply.” 

Oral GLP-1s are generally expected to be cheaper than injectables due to simpler manufacturing and distribution. While still costly, they could come in below injectable list prices, Williams said. But for employers, the total cost of care could increase meaningfully because of higher utilization.

“While the innovation improves access, it also raises the risk that total GLP-1 spend could climb rapidly unless employers are actively managing who can access these therapies and how they’re used over time,” Williams said. 

Tool: GLP Calculator

Will It Affect Coverage? 

Rae McMahan, senior vice president of payor solutions at Redmond, Wash.-based health firm Prescryptive, said that she doesn’t think that the introduction of the drug form will change whether employers offer GLP-1s. “These drugs are amazingly effective for managing diabetes and helping with weight loss,” she said. “I think employers will look at cost, efficacy and health outcomes to determine whether covering these medications makes sense.”

Conway agreed, noting that “employers already covering weight loss medications should be able to offer employees access to both pills and injectables.” 

“Those who do not currently have coverage of injectables would also likely not have coverage of the new oral medication,” he said. “This development alone is unlikely to change an individual’s access to weight-loss medications.”

Cost Questions 

The introduction of GLP-1 pills — and the likely boost in utilization — creates a classic tension for employers, Williams explained. “There is a compelling long-term value story here, particularly if improved weight management leads to reductions in chronic conditions and better overall workforce health,” she said. “But in the short term, it’s a cost story. More users combined with high-cost therapy can drive a level of spend acceleration that outpaces anything we’ve traditionally seen in pharmacy.”

Without clear guardrails, “this is a category that can scale very quickly,” she added. 

Employers already have been struggling with GLP-1 costs. The price of the drugs — the brand-name injectable drugs typically cost between $1,000 and $1,500 a month for consumers, and employers may foot 70% to 100% of that bill — have been significant and have given many employers pause about covering them. Prescription drug costs are increasing around 13%-15% annually — and GLP-1 costs are fueling much of this growth as they currently comprise roughly 20% of total prescription drug costs, according to Aon data. Total GLP-1 spend increased around 50% in 2025 due to heightened utilization. 

“At a time when employers are already facing cost pressures from rising utilization in the weight-loss drug category, the new GLP-1 pills could accelerate that pressure when most are trying to reduce costs,” Conway said. “For employers looking to control costs and cover these medications, it’s putting more fuel on an already burning fire.” 

What Should Employers Consider?

Employers need to approach GLP-1 coverage as a strategy decision, not just a coverage decision, so there are several key considerations at play, Williams said. Those include cost projections, eligibility criteria — whether it’s BMI thresholds, comorbidities, or step therapy requirements — and understanding clinical appropriateness and duration. “GLP-1s are not short-term therapies, so employers have to decide how long they’re willing to fund treatment and what success looks like,” she said. 

Employers should also consider the level of guidance and support employees receive, such as nutrition, behavioral health, and ongoing clinical guidance. “These additional factors can shape the member’s health outcome,” Williams said.

Conway added that point of distribution is also key.  

“Most employers today are accessing these medications through their pharmacy benefits manager, but a growing number are turning to third-party point solutions,” he said. “Understanding where and how employees are accessing these medications is becoming increasingly important as the landscape evolves.”