Employer survey finds 14 percent have dropped or plan to drop GLP-1 coverage for 2027

About 14 percent of US employers have already ended or plan to end coverage of GLP-1 weight-loss drugs in 2027, according to a Business Group on Health survey released August 25 ^[1]. The group, which advocates for employer health policy and benefits, polled companies ranging in size from fewer than 5,000 workers to more than 100,000 ^[1].

The survey projected that employer healthcare costs would climb 9.2 percent in 2027 if companies make no changes to manage spending, compared with 8.5 percent for 2026 ^[1]. The Business Group on Health has reported consecutive increases in expected costs every year since 2022 ^[1].

Two-thirds of the employers said use of the drugs is rising ^[1].

Coverage of the medicines for weight loss was already narrowing before the 2027 plans: 72 percent of employers covered them in 2025, and 60 percent did in 2026 ^[1].

Pharmacy accounts for one-quarter of employer healthcare spending, a slice the group expects to grow 12 percent in 2027, the same rate of increase as the year before ^[1].

"This represents an unfortunate new reality for employers, who now face growing difficulty in budgeting and forecasting," said Ellen Kelsay, president of the Business Group on Health. "It's a call to take a more disruptive approach and rethink how to deliver value and improved health outcomes." ^[1]

Kelsay attributed the pressure to rising hospital prices, pharmacy costs and policy changes. She said more employers are now encouraging the use of cheaper biosimilars, cutting coverage for complex or specialty drugs, and looking at alternative pharmacy arrangements ^[1].

Brenna Shebel, a vice president at the group, said most companies that offer the drugs for weight loss have not yet seen them bring down the cost of treating related conditions such as diabetes or sleep apnea ^[1].

Manufacturer list prices cited in the report are $499 a month for Zepbound (tirzepatide) and $1,349.02 a month for Wegovy (semaglutide) ^[1]. The report named Novo Nordisk's Wegovy and Eli Lilly's Zepbound and Foundayo (orforglipron) as examples of the drugs involved ^[1]. PepsiCo is dropping weight-loss drug coverage for employees, Bloomberg News reported, as summarized by STAT ^[2].

Cancer was the condition most often named as a cost driver, cited by 70 percent of firms, up from 58 percent in 2025 ^[1]. Musculoskeletal and cardiovascular conditions followed; the group said treatments for those conditions involve more complex therapies ^[1].

Why it matters for patients

For adults whose drug coverage comes through a job, these decisions are made one company at a time. A change at one employer does not alter coverage at another, and the survey does not identify which companies are dropping GLP-1 coverage or when a change would take effect ^[1].

It also does not say whether an employer that stops covering the drugs for weight loss would keep paying for the same medicines when they are prescribed for other uses, such as diabetes or cardiovascular conditions. That has not been reported ^[1].

The dollar figures in the report are list prices, not what a patient pays at the pharmacy counter. The sources do not give a figure for what someone would owe out of pocket if a plan stops covering Wegovy or Zepbound ^[1].

The trend line on coverage has been steep: a 12 percentage point drop in employer coverage for weight-loss use in a single year ^[1]. At the same time, two-thirds of employers report rising use of the drugs, one of the cost pressures tied to the decisions being made ^[1].

What happens next

The figures describe employer intentions for the 2027 plan year, and the survey does not give dates for when coverage would end or which specific products would be affected ^[1]. Whether some employers plan to add GLP-1 coverage while others drop it is not broken out in the report ^[1].