Some US employers plan to drop GLP-1 weight-loss coverage in 2027

Two surveys of large US employers found that a minority plan to stop covering GLP-1 drugs for weight loss in 2027, even as demand for the medicines keeps rising ^[1].

About 10% of employers that now cover GLP-1 drugs for weight loss said they planned to drop the drugs in 2027, according to the Business Group on Health, a policy research group for large employers. A separate survey by benefits consultancy Mercer found that 5% of large employers — which it defines as those with more than 500 employees — plan to drop coverage of the drugs in 2027 ^[1]. The two surveys give different estimates of the pullback, but both suggest that most employers covering the drugs for weight loss intend to keep doing so.

Business Group on Health data show 67% of large employers cover GLP-1s in 2026. Mercer said 44% of companies with more than 500 employees cover the drugs for obesity ^[1]. Health insurer Cigna stopped covering the weight-loss treatments for its own employees effective in July; the company said they could buy the medicines elsewhere, Reuters reported this month ^[1].

Lower-cost pills are part of the picture. Novo Nordisk launched the Wegovy pill in January, and Eli Lilly began selling its Foundayo pill in April; both start at about $149 a month ^[1]. Wegovy contains semaglutide; Foundayo contains orforglipron. The pills are available through the drugmakers' own websites at discounted prices, driven by a deal with the Trump administration for its site TrumpRx.gov ^[1].

Demand for the drugs has increased this year because of the oral options, attracting people who have never before tried a GLP-1, according to five industry experts. That has kept employer costs high ^[1]. The experts said employers are also seeing people stay on GLP-1s long term and a larger pool of people eligible for the medications, compared with other treatments ^[1]. Foundayo and Wegovy have been shown to reduce weight by 11% and 14%, respectively, less than the injected drugs but preferable for patients who fear needles ^[1].

Lauren Remspecher, a director at Purchaser Business Group on Health, said many employers are still concerned they are not seeing the same savings in their deals with pharmacy benefit managers — industry middlemen who negotiate prices for large companies and health plans — as customers who buy directly and pay cash ^[1]. "One advantage of having the direct-to-consumer and some of the government-negotiated pricing more transparent is that now employers can see how much more they're paying and where there is an opportunity for improvement," she said ^[1].

Louis Zollo, a pharmacy practice leader at healthcare consultancy Segal, said, "Even though we have seen the unit cost come down, the patient population keeps growing" ^[1]. Benefits consultancy Aon has observed injectable customers shifting to oral versions, as well as new GLP-1 patients choosing the pills, and said it expects GLP-1 coverage to decrease next year ^[1]. Dan Mendelson, CEO of Morgan Health, a healthcare unit owned by JPMorgan, said the pills are set to push the cost of the individual treatments down this year. "But every year there's going to be market growth," he said. "There's going to be more people taking these drugs, so on aggregate this still represents a major cost driver for employers" ^[1].

Why it matters for patients

Employer decisions set what a workplace health plan pays for, so a change for 2027 would affect whether a GLP-1 used for weight loss stays covered and what a member pays at the pharmacy. Which specific employers plan to drop coverage has not been disclosed; the surveys report shares of employers, not company names ^[1]. Whether a plan that drops weight-loss coverage would still cover the same drugs for other uses has not been reported.

For people whose coverage ends, the drugmakers' direct-pay programs are one listed option, with the pills starting at about $149 a month ^[1]. The surveys do not say how many people could be affected, or whether employers that keep coverage will change how the drugs are covered. Those details have not been reported.

What happens next

Cigna's coverage of the weight-loss treatments for its own employees ends in July ^[1]. The two surveys look ahead to the 2027 plan year, and the employers that said they plan to drop coverage have not been identified ^[1]. Novo Nordisk's Wegovy pill and Eli Lilly's Foundayo pill, launched in January and April respectively, continue to be sold directly to consumers at about $149 a month ^[1].