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GLP-1 Drug Impact on Employee Health Plans. Ozempic and Mounjaro are the two main GLP-1 medications used to treat Type 2 Diabetes. Wegovy and Zepbound are the two main GLP-1 medications used to treat obesity. GLP-1 medications account for 9% of an employer's prescription medication spend on average, yet only 1.7 percent of plan members are on GLP-1 medications. Twelve percent of US adults have type 2 diabetes and 42 percent of US adults are obese, so if only 1.7 of plan members are on GLP-1s, then their overall prescribing is just barely getting started. GLP-1 medications cost $9,000 to $10,000 per person per year after PBM discounts and rebates. They comprise two of the top four medications by total overall spend by employers. Strategies to Lower Spending on GLP-1s by Employers Include: 1) Prior Authorization - HOWEVER, if an employer chooses to only cover GLP-1 medications for plan members above a certain BMI, then the pharmaceutical manufacturers will refuse to pay them rebate dollars--thus raising the overall cost of the medications. 2) Step Therapy 3) Non-Coverage Alternatively, GLP-1 medications pose such a great financial burden to employers that they may agree to a single-payer healthcare system run by the Government as a way of addressing the problem. Sources: https://www.wtwco.com/en-us/insights/2024/02/glp-1-drugs-implications-for-employer-health-plans https://blog.ifebp.org/employer-coverage-of-glp-1-drugs-on-the-rise/ https://www.cnbc.com/2024/06/18/healthy-returns-more-us-employers-covering-glp-1s-for-weight-loss.html#:~:text=Roughly%20one%2Dthird%20of%20employer,member%20companies%20or%20public%20institutions. https://www.biopharmadive.com/news/employers-healthcare-cost-growth-2025-pharmacy-glp1s/724966/ https://www.businessgrouphealth.org/en/newsroom/news%20and%20press%20releases/press%20releases/2025%20employer%20health%20care%20strategy%20survey https://www.biopharmadive.com/news/eli-lilly-zepbound-obesity-sales-second-quarter-guidance/723679/ https://www.goodrx.com/classes/glp-1-agonists/glp-1-drugs-comparison AHealthcareZ is 400+ Healthcare Finance Educational Videos. 💥 BOOK: Check out Dr. Bricker’s Book 16 Lessons in the Business of Healing here: https://www.ahealthcarez.com/healthcare-money-campfire-stories-book AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health. 90,000+ Views Per Month Across All Platforms. Visit AHealthcareZ.com to Subscribe to the Healthcare Finance Video Newsletter.

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