A new survey from the International Foundation of Employee Benefit Plans found that employers are encouraging their employees to obtain GLP-1 receptor agonists for weight loss through direct-to-consumer platforms and using their health savings or flexible savings accounts to pay for those medications.
According to the survey, 27% of employers encourage the use of direct-to-consumer platforms, and 21% encourage employees to use their savings accounts.
Employer Coverage of GLP-1 Drugs
Justin Held, director of educational programs at the International Foundation of Employee Benefit Plans, said that instead of covering the drug within the plan, companies give employees some seed money in the flexible spending account.
The FSAs or HSAs can help reduce the cost burden for employees if they have a monthly subscription service on a direct-to-consumer platform.
Held noted that as more of these drugs go the direct-to-consumer route, this trend will continue going forward.
Survey Findings
The survey, conducted from June 2, 2026, to June 12, 2026, captures U.S. employers’ coverage and considerations surrounding GLP-1 drugs.
Cost remains a primary driver in employer decisions about GLP-1 coverage for diabetes, weight loss, and other indications, the survey found.
Of those surveyed, 60% of employers provide coverage for diabetes only compared with 55% in 2025, 57% in 2024, and 49% in 2023.
But just 36% provide coverage for both diabetes and weight loss, an increase from 34% in 2024 and 26% in 2023.
Considerations for Coverage
When asked if they would consider coverage of GLP-1 for weight loss, 9% of those who already provide coverage for diabetes said they might consider it, but 62% said they wouldn’t.
Justin Held said that some employers may have tried covering GLP-1 for weight loss in the past but pulled back due to lack of expected results.
Evidence is beginning to emerge that GLP-1 drugs may have benefits for weight loss, including reduced medical cost growth and lower claims incidence for certain conditions.
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Aon released results of an analysis that showed among people using GLP-1s for 18 months for weight loss, there was a pattern of reduced medical cost growth and reductions in hospitalizations due to major adverse cardiovascular events.
The analysis was from a representative sample of 192,000 GLP-1 users from commercial medical and pharmacy claims.
Justin Held noted that of those employers that do provide coverage for weight loss, 20% go through a dedicated weight management vendor solution.
The survey found that there were 10 factors that employers consider when assessing GLP-1 coverage for weight loss.
These factors include chronic care management, obesity as a risk factor for chronic diseases, and the impact of cost-control mechanisms on health insurance premiums.
For instance, 58% of employers consider broker or consultant recommendations when deciding on GLP-1 coverage.
Additionally, 46% of employers consider obesity as a risk factor for chronic diseases and associated costs.
The findings from the survey show a continuing trend of payers being concerned about the high cost and affordability of GLP-1 drugs for obesity.
Last month, Pharmaceutical Strategies Group released its Trends in Drug Benefit Design report, which found that payers are also questioning patients’ lack of adherence and the impact of that on overall spend.
Nearly two-thirds of patients without Type 2 diabetes who take GLP-1s discontinue treatment within one year.
As the use of GLP-1 receptor agonists for weight loss continues to evolve, it will be important for employers and payers to consider the various factors that influence coverage decisions.
