Surveys show U.S. employers are trimming some weight-loss GLP-1 coverage for 2027 as benefit costs climb, while others consider subsidies for workers buying the medicines outside traditional plans.
Business Group on Health said its June survey of 127 employers representing 11 million people with health coverage found that 60% covered GLP-1 medicines for weight management in 2026, down from 72% in 2025. The group said 14% had ended coverage or planned to end it in 2027. Mercer found that 6% of large employers had dropped weight-loss GLP-1 coverage in 2026, while another 5% planned or were considering doing so in 2027. Twenty-seven percent had tightened rules governing use or planned to do so.
KFF’s 2026 survey of 1,937 non-federal public and private employers found that 18% of firms with at least 200 workers covered GLP-1s primarily for weight loss in their largest-enrollment plan, close to 19% in 2025. Among firms with at least 5,000 workers, the share fell to 33% from 43%. These surveys asked different questions of different groups, so their findings do not add up to one national coverage rate. KFF says plans generally cover GLP-1 medicines prescribed for diabetes.
Marsh’s preliminary survey, based on responses from more than 1,800 U.S. employers through Aug. 10, projected average health benefit costs per employee would rise 8.2% in 2027 after planned reductions, compared with 11% without them. Marsh estimated rising GLP-1 use would add one percentage point to the increase, and cited other pressures such as higher-cost treatments, health system consolidation, AI-enabled billing and out-of-network dispute payments. It said 59% of surveyed employers planned benefit cost cuts in 2027, including higher deductibles. “Few organizations can absorb health cost increases that outpace inflation without making difficult financial decisions,” said Simon Camaj, Marsh’s U.S. Health and Benefits leader.
WTW’s June survey of 294 clients with more than 2.8 million plan members found that 66% covered GLP-1 medicines for obesity. Among those employers, 70% intended to maintain coverage; 12% were likely or very likely to discontinue it, and 18% were somewhat likely to do so. Fourteen percent said they were likely or very likely to redirect coverage to a direct-to-consumer channel by Jan. 1, 2027; 7% said the same about direct-to-employer arrangements.
Cash-pay prices depend on the drug, dose and offer terms. NovoCare lists Wegovy pill prices of $149 a month at 1.5 mg, $199 at 4 mg, and $299 at 9 mg and 25 mg. Its $199 monthly offer for new patients using the lowest injectable doses covers the first two fills through Dec. 31, 2026; the listed price afterward is $349 a month for injectable doses from 0.25 mg to 2.4 mg. Novo Nordisk says offer terms may change. LillyDirect lists Zepbound KwikPen prices of $299 per 28-day month for 2.5 mg, $399 for 5 mg and $449 for doses from 7.5 mg to 15 mg, subject to refill timing. Lilly identifies 2.5 mg as a starting dose, not a maintenance dose.
GoodRx’s Employer Direct program lets employers subsidize discounted manufacturer cash prices without adding the medicines to a traditional insurance benefit. GoodRx named Hy-Vee as an initial employer partner; the subsidy depends on the employer’s terms. The Internal Revenue Service says prescribed medicines and weight-loss treatment for a physician-diagnosed disease such as obesity can qualify as medical expenses. For 2027, the agency set health savings account contribution limits at $4,500 for self-only coverage and $9,000 for family coverage. NovoCare’s current introductory injectable offer is listed through Dec. 31, 2026.
