Covering GLP-1 drugs for weight loss was a hard call for a lot of employers. Ending that coverage is turning out to be a hard call too.
According to a Business Group on Health survey of 105 employers, 67% cover GLP-1s for weight management. Of those, only 72% say they're likely to keep that coverage in 2027, and 10% say they likely won't. Nearly eight in 10 say the drugs are pushing up their health care costs, and few have seen the payoff show up in their claims yet.
Companies cannot ignore the reality that GLP-1s have significant implications for health care budgets – and overall affordability.
Ellen Kelsay, President and CEO, Business Group on Health
If you're in that 10%, or tightening access instead of ending it, the decision itself is only half the work. The other half is the people who are on the medication the day the coverage stops.
What happens when employees stop GLP-1s
When people stop a GLP-1 and don't restart, the weight tends to come back, and it comes back fastest at the start. A 2026 meta-analysis of six trials and 3,236 people found regain levels off at about three-quarters of the weight lost.
That's the trial picture, where the drug is withdrawn and people are watched. Real life looks gentler, and the reason matters for your plan. In a Cleveland Clinic study of nearly 8,000 adults who stopped within a year, the obesity group had lost 8.4% of their weight and regained just 0.5% a year later. Many didn't simply stop. Across the whole study, 27% switched medications, 20% restarted the one they'd been on, and 14% turned to lifestyle programs.
So the outcome for your employees depends a lot on what they do next. Coverage ending doesn't take that choice away from them. It changes who's paying for it.
Many will keep taking them and pay out of pocket
Self-pay prices now sit far below list price. As of this writing, the federal TrumpRx site lists these monthly cash prices:
| Medication | Monthly self-pay price |
|---|---|
| Wegovy pill (semaglutide tablets) | $149 to $299, by dose |
| Wegovy injection | $349 for most doses, $399 for the 7.2 mg dose |
| Zepbound vials (tirzepatide) | $299 to $449, by dose |
Prices listed on TrumpRx, read September 30, 2026. Wegovy's $199 new-patient price isn't shown because it ends December 31, 2026. Manufacturer offers change. A prescription is still required.
That's real money, but it's within reach for a lot of employees who've been paying a copay. Two things follow for you.
First, those employees don't disappear. They're still on the medication, still managing side effects and still working on the habits that decide whether the weight stays off. They've just left your claims data, so you can't see them anymore.
Second, they're paying outside your plan. Under the self-pay terms, what they spend can't count toward your plan's deductible or out-of-pocket maximum. Expect questions about that at open enrollment, and have the answer ready.
A transition plan for dropping GLP-1 coverage
Here's what we'd do in the months before the change takes effect.
There's trial evidence behind step 3. In a Danish trial, people coming off liraglutide alone regained 6.0 kg more in the following year than people coming off a year of supervised exercise. That's a comparison between the two groups, not a measure of how much anyone regained. The weight held up better after the exercise ended than after the drug did.
If your plan design is changing rather than ending, with new clinical criteria or a program requirement, read up on the ADA questions before you finalize it.
What employees on GLP-1s want from support
We've seen what this group engages with. Across 2,981 members who took our two GLP-1 courses, nearly 8 in 10 finished each course, and more than 93% said they'd recommend them. Over a quarter started the first course without knowing the drug's possible side effects. And 7.1% of people starting the second course had already used the medication and stopped, which is exactly the group a coverage change creates. Those figures are self-reported, with no control group. They show that people use this kind of support. They don't show that it changes weight.
Our view: dropping coverage for a drug is a budget decision. Leaving the people on it with nothing is a separate decision, and nobody has to make it. A coaching-led program reaches the employees who keep paying on their own and the ones who stop, and gives you back a way to see how they're doing.
