If it feels like everyone you know is on a GLP-1, that’s because a lot of people are. A KFF poll found 1 in 8 adults are taking medications like Wegovy or Ozempic to manage their diabetes, obesity and other serious health conditions.
These drugs are life-changing for many people, but the high demand — and high price tag — are causing big budget problems for employers.
“The watch word of 2026 is cost containment,” said Ann Lewandowski, who advises large companies on their health insurance benefits. “How are we going to contain this cost?”
With 40% of American adults living with obesity, covering GLP-1s for weight loss has sent employers’ prescription drug costs skyrocketing. Yet companies are eager to offer GLP-1s as a way to attract and retain workers: One survey found that nearly one-third of employees say they would switch jobs to gain access to a GLP-1.
Tradeoffs talked with more than 30 employers, researchers and consultants to try to understand how companies are trying to thread the needle of improving their employees’ health, while not breaking the bank. In addition to common cost-control strategies like requiring prior authorization and increasing cost-sharing, many employers are turning to more novel approaches.
Below are three of the most common solutions employers are using, along with their pros and cons, according to experts.
Lifestyle programs:
What are they? Employees are expected to jump through some kind of hoop to receive their GLP-1. Common examples include app-based diet and fitness programs, consultations with nutritionists and online trainings about the science of obesity.
What do employers like about them? Employers have more control over who takes these drugs, allowing them to limit their spending. “If you take this drug but you still eat fast food and you still don’t exercise … then we’re just basically wasting money on that drug and you’re wasting your time,” said Sean Scanlon, comptroller for the state of Connecticut, which is using one of these programs for its workers.
Many lifestyle programs also give employers tools to track outcomes, both financially and for worker health. Connecticut says connecting coverage of GLP-1s to an obesity management program has led to major reductions in workers’ cholesterol, blood pressure and glucose levels, and cut the state’s spending increases on these drugs by one-third.
How common are they? In 2025, one in three employers said they required lifestyle or clinical support programs before allowing employees to receive GLP-1s for weight loss. The federal government is also launching a voluntary pilot program in May that will allow state Medicaid agencies and Medicare Part D insurers to receive discounted GLP-1s for enrollees if they pair the medications with lifestyle interventions.
What don’t employers like about them? A lot of vendors have popped up to offer this service, and it can be time-consuming for employers to assess their quality. It could also open them up to legal liability — some companies are being sued for imposing discriminatory barriers to GLP-1s.
What do they mean for employees? It creates additional work for employees to access medications they could benefit from — work they don’t have to do for most other medical conditions. On the other hand, some employees find the combination of GLP-1s and lifestyle programs more helpful than the medications or diet and exercise alone.
Reimbursement programs:
What are they? Employers offer workers a set dollar amount to spend on GLP-1s directly from pharmaceutical companies or online retailers. Reimbursement amounts vary but are often $200 to $400 a month.
How common are they? Experts say there are no good estimates on how many employers are using reimbursement programs because they are a relatively new strategy. Multiple analysts say the trend is driven in part by pharmaceutical companies offering lower prices for consumers to buy GLP-1s directly.
What do employers like about them? It’s very simple for employers to set up and implement. Lewandowski summed it up as, “ Hey, here’s some money. Go take it and spend it however you want.” Employers also have the flexibility to pick a reimbursement level that fits their budget.
What don’t employers like about them? Employers have no information about if and how GLP-1s are impacting the health of their employees.
What do they mean for employees? They receive some contribution from their employer to help cover the costs. But employees have to do the work to make the actual purchase, and they are still on the hook to pay up to several hundred dollars per month out of pocket.
Dropping coverage:
What is it? A growing number of employers have stopped covering GLP-1s for weight loss after seeing their budgets balloon in the last few years.
How common is it? In 2026, according to researchers at the prescription drug comparison site GoodRx, more than 16 million people with commercial insurance lacked coverage for GLP-1s prescribed for weight loss.
What do employers like about it? Employers save money that they can use to cover other types of health care — like pregnancy care and cancer treatments — that they think will be more valuable to their employees. They also argue it allows them to offer higher wages. One senior executive in the insurance industry told me that even a 1% increase in health care costs can keep employers from raising employee pay.
What don’t employers like about it? They lose out on a powerful recruiting tool to entice new employees. “Most employees consider GLP-1s, particularly for weight loss, a very attractive benefit,” Lewandowski said.
What does it mean for employees? Some could benefit from their companies investing in other medical services. Those who still want a GLP-1 are left paying hundreds of dollars per month out of pocket — or taking a risk on unregulated and potentially dangerous options.
One-quarter of people on GLP-1s say they bought them from an online provider or medical spa, instead of through a primary care physician or specialist. These online retailers are popular because they offer cheaper options. But they operate with little regulation, and some illegally sell copycat versions of brand-name GLP-1s — making it difficult for consumers to know what they’re putting in their bodies.