GLP-1 Coverage Linked to Higher Utilization and Costs in Employer-Sponsored Health Plans
Key Takeaways:
- Among 5787 employer-sponsored health plans, coverage of glucagon-like peptide-1 (GLP-1) medications remained low, with 14.2% covering GLP-1s in January 2021 and 14.9% covering GLP-1s in December 2024.
- GLP-1 prescription fills increased during the study, with plans offering coverage having a greater increase in GLP-1 utilization than plans that did not.
- Increases in GLP-1 utilization could lead to higher health care spending, with coverage raising per member per month (PMPM) costs by $9.23 at 2025 prices.
Although the clinical benefits of GLP-1 medications for obesity have been well-established, high drug costs are associated with increased financial burden for both patients and payers.
Researchers conducted a cross-sectional study of GLP-1 prescription trends between employer-sponsored plans that cover GLP-1s for weight loss and those that do not.
Using data from between 2021 and 2024 from employer-sponsored health plans utilizing UnitedHealthcare, investigators assessed prescription fills and PMPM costs of GLP-1 drugs.
The study identified 6.3 million individual patients, 5787 plans, and 1756 employers. Only 14.2% of plans covered GLP-1s in January 2021, and 14.9% covered GLP-1s in December 2024.
GLP-1 Prescriptions Trends
At the beginning of the study, plans that covered GLP-1s had 5.5% more utilization than plans that did not cover GLP-1s, 128.2 days supplied per 1000 enrollees vs 121.5 days supplied per 1000 enrollees, respectively.
Both cohorts had increases in prescription fills by December 2024, and plans offering GLP-1 coverage experienced a greater increase, 1260 days supplied per 1000 enrollees compared to 766.8 days supplied per 1000 enrollees. This resulted in a 64.3% gap in GLP-1 prescriptions.
Utilization estimates for 2024 suggest that GLP-1 coverage increased PMPM costs by $16.21 at 2021 prices and $9.23 at 2025 prices, which could imply increased health care spending for obesity medications.
Implications for Managed Care
These findings show a significant increase in GLP-1 prescription fills, especially among patients receiving coverage. Future research evaluating the costs of GLP-1 drugs for weight loss is needed.
The authors said, “With increases in utilization, the estimate of differential PMPM cost for GLP-1 coverage is increasing over time and could signal higher financial burden on patients and payers in the future, though some of the added drug cost (yet unquantified) is likely offset by lower medical spending.”
Reference
Shahzad M, Advani P, Akintola O, Chernew M. GLP-1 prescriptions for weight loss by differences in insurance plan coverage. JAMA Health Forum. 2026;7(6):e261838. doi:10.1001/jamahealthforum.2026.1838
