Jim Lantieri, Guest Writer and Summer Intern
GLP-1 medications, just three years ago, were focused nigh-entirely on diabetes treatment, but have seen a resurgence through their expansion into weight management and broader disease care. With prescriptions rising across multiple unintended conditions, these drugs are becoming a major factor in pharmacy claims for employer health plans.
As more employees seek access to drugs like Ozempic, Wegovy, and Mounjaro, employers see a significant shift in both cost exposure and plan utilization. For benefit leaders, the growth of GLP-1 drugs requires careful consideration of plan design, financial sustainability, and long-term workforce health outcomes.
GLP-1 Spending Continues to Climb
Recent data shows how quickly GLP-1 use is affecting employer pharmacy spend. GLP-1 medications accounted for 17% of pharmacy benefits spending for employer groups with self-funded plans in 2024, up from 13% the year prior.
Ozempic, primarily prescribed for diabetes, remains the most used GLP-1 drug, followed by Mounjaro, Wegovy, Zepbound, and Trulicity. The rapid growth reflects not only higher utilization but also expanding FDA approvals and growing off-label use for obesity and related conditions.
Other reports show similar trends. Estimates indicate 11 percent of overweight or obese patients received a GLP-1 prescription in 2024, compared to just 2.5 percent in 2019. According to the International Federation of Employee Benefit Plans, 36 percent of surveyed employers now cover GLP-1 medications for both diabetes and weight loss.
The clinical upside of GLP-1s is clear; they reduce the risk of over 200 chronic conditions, including diabetes, cardiovascular disease, and certain cancers. But the financial reality is harder to swallow. The average monthly cost for GLP-1 medications ranges from $900 to $1,300 per member, with annual expenses often exceeding $15,000 per patient.
Moreover, employees who successfully manage weight and chronic conditions through GLP-1 therapy often experience improved health, which usually results in fewer future claims, stronger job satisfaction, and higher retention.
How BSI Is Guiding Clients Through GLP-1 Plan Design
BSI is actively partnering with employers to navigate the growing clinical and financial complexities of GLP-1 medications. As demand for these therapies expands, particularly for weight management, BSI begins each engagement with a comprehensive review of the client’s pharmacy benefit design. This includes analyzing current GLP-1 claim trends, identifying coverage gaps, and modeling future utilization based on workforce risk profiles.
From there, BSI collaborates with carriers and pharmacy benefit managers (PBMs) to design tailored coverage strategies that strike the right balance between member access and cost containment. This includes defining clinical eligibility criteria, enhancing prior authorization protocols, applying utilization guardrails, and creating clear member communication to improve understanding and adherence.
To further manage costs, BSI offers integrated point solutions, which can reduce the net cost of select high-cost medications by up to 60%, without compromising access.
Preparing for the Expanding Role of GLP-1 Medications
GLP-1 medications are no longer such a minor concern for pharmacy plans. Their unexpected growth is forcing employers to reevaluate coverage decisions and cost management strategies.
BSI continues to help employers navigate these challenges by providing informed guidance on plan design, cost control, and employee education. Our goal is to help employers make thoughtful decisions that balance financial responsibility with member care.
Related BSI Insights
Learn more about how pharmacy cost trends intersect with broader plan management in Maximizing Savings: Transitioning to HSA-Eligible Plans.
For further perspective on how demographics shape benefits decisions, see Adapting to the Unique Needs of Employees at Different Life Stages.