Photo Illustration of the new Wegovy semaglutide tablets with injectable prescription weight loss medicines, Ozempic, Victoza and Wegovy. Its a prescription medicine used with a reduced calorie diet and physical activity. (Photo by: Michael Siluk/UCG/Universal Images Group via Getty Images)
UCG/Universal Images Group via Getty Images
A recent report highlights that GLP-1 weight loss drugs, including Ozempic, Zepbound, and Wegovy, are major drivers of increased prescription costs in employer healthcare plans.
This rise in spending is detrimental to employees’ out-of-pocket expenses.
The 2026 Milliman Medical Index indicates that the yearly cost of insuring a family of four has surpassed $35,000, marking a 7.2% increase from 2025 to 2026. According to Milliman, the “expected employee contribution plus out-of-pocket costs” accounts for 58% of this total, or approximately $15,000.
According to Milliman, “Pharmacy is the fastest-growing cost component of the MMI in 2026, rising 14.8% year-over-year for the average person,” with prescription drug costs estimated to be 13% of the total family health spending in 2026, or $4,700. They noted, “There are many factors at play when it comes to increasing healthcare costs for employers and employees. GLP-1 drugs for diabetes and weight-loss management have become a meaningful and growing component of pharmacy spend, and will continue to impact employer pharmacy costs in 2026.”
As employer healthcare costs increase, companies often pass more expenses onto employees through higher premiums deducted from paychecks or through cost-sharing mechanisms such as co-payments or deductibles.
Even before this year, employers were considering whether to include GLP-1 drugs in their coverage or to exclude them entirely. According to The Business Group on Health, “The percent of employers covering GLP-1s for conditions other than diabetes will stagnate as employers try to stabilize their health care costs, while more of those that cover these medications for weight loss will require utilization management, prescriptions from specific providers, participation in a weight management program and higher expectations from vendor partners to deliver sustainable, cost-effective financial models for this class of medications,” as stated in a report last August.
An additional analysis by the Business Group on Health earlier this year found that only 72% of employers covering GLP-1 drugs for weight management plan to continue doing so in 2027, while 10% indicated they would likely discontinue this coverage, according to the organization’s statement.
A report from last month revealed that specialty drug costs, including GLP-1 drugs, pose a greater challenge for health plans and employers to manage than the overall cost of care. According to a report by Pharmaceutical Strategies Group (PSG) presented at Asembia ASX26 in Las Vegas, 43% of health plans prioritize managing specialty drug costs over the total cost of care, which 41% identified as their main focus. This analysis included responses from 228 health benefits executives from health plans, employers, and unions.
“Payers continue to prioritize managing specialty drug trend and total cost of care,” said Morgan Lee, vice president of research and marketing at PSG. “At the same time, they are working to develop effective coverage strategies for new drugs and expanded indications, take a more integrated approach across pharmacy and medical benefits, and reassess traditional arrangements, including their reliance on rebates.”
