Facing High GLP-1 Costs, Employers Shake Up Pharmacy Strategies

As employers continue to weigh decisions about GLP-1 coverage for their workforce, many organizations are still not covering the pricey drugs for weight management, new SHRM data finds. And a growing number are looking at pharmacy changes as they struggle with costs for those drugs.

While roughly half of 5,500 employer respondents (47%) covered GLP-1s for Type 2 diabetes management, only 15% did so for weight management, according to the newly released 2026 SHRM Employee Benefits Survey.   

GLP-1 drugs are showing promise for improved health outcomes, but the fact that 1 in 8 adults are currently taking a GLP-1, according to KFF — coupled with the enormous price tag — is giving many employers pause.

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. 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.  

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“Against the backdrop of anticipated double-digit healthcare cost increases, fueled to a large degree by GLP-1s and overall prescription drug costs, companies cannot ignore the reality that GLP-1s have significant implications for healthcare budgets — and overall affordability,” said Ellen Kelsay, president and CEO of Business Group on Health (BGH) in Washington, D.C.  

SHRM’s new data on employer coverage of GLP-1 drugs comes on the heels of other findings showing that some employers are reconsidering GLP-1 coverage for weight loss. Consulting firm Mercer earlier this month found that 6% of large employers dropped GLP-1 coverage this year. Another recent survey from BGH found that of employers covering GLP-1s for weight management, only 72% said they were likely to continue coverage for the drugs in 2027, while 10% said they likely would not.

It’s not all that surprising that some employers are rethinking coverage for GLP-1s, said Sara Izadi, chief clinical officer at New York City-based health technology company Judi Health. 

“Employers continue to face mounting pressure to manage rising pharmacy and healthcare costs and, in many cases, have yet to see clear ROI from GLP-1 utilization in their own employee population,” she said.

Employers Alter Prescription Drug Strategies 

The pricey drugs may be one reason why employers are increasingly shaking up their prescription drug benefits strategies. The SHRM survey showed a 16 percentage point year-over-year decline in the number of employers that bundled prescription drug coverage with their health insurance — 77% of employers bundled coverage in 2026, down from 93% in 2025. At the same time, the percentage of employers utilizing independent pharmacy management programs jumped to 23% in 2026, up from 18% in 2025.

Those findings are likely proof that employers are becoming more deliberate about managing prescription drug costs. While fewer employers are offering prescription drug coverage as a simple bundled component of medical insurance, more are adopting pharmacy management programs to gain greater control over utilization, costs, and access to high-cost medications such as GLP-1s and specialty drugs. 

Tool: GLP-1 Calculator

Experts say that employers must look for new ways of holding down expensive prescription drug prices. Turning to pharmacy benefit programs is one way to do that. 

“Given the demonstrated efficacy of these therapies, coverage decisions are evolving beyond a simple yes-or-no,” Izadi said. “Employers are increasingly shifting focus toward robust utilization management and clinical oversight programs to ensure GLP-1s are prescribed appropriately and deliver sustainable value.”