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

More employers and health plans are balking at paying for costly GLP-1 drugs like Ozempic, Zepbound and Wegovy for weight loss and the treatment of obesity, according to a new Pharmaceutical Strategies Group report.

A survey of benefits executives at more than 235 employers, health plans and unions showed nearly half, or 49%, of firms that do not currently cover GLP-1s for obesity would “not do so at any price,” PSG said in a statement accompanying its 2026 Trends in Drug Benefits Report released Tuesday. Meanwhile, 9 in 10 of the respondents from plans with a median of 14,000 enrollees said they were “moderately” or “very concerned” about the affordability of GLP-1 therapies for the plan.

“As drug costs climb, payers are under pressure to re-evaluate benefit design and cost management strategies,” said Morgan Lee, vice president of research and marketing at PSG. “The debate around GLP-1 coverage is a prime example of the balancing act benefits leaders face as they navigate skyrocketing demand, affordability concerns, and uncertainty around long-term patient outcomes.”

Just last week, Cigna confirmed it was no longer covering GLP-1 weight loss drugs for its own employees effective July 1.

The change, however, doesn’t impact coverage of the prescriptions for the treatment of Type 2 diabetes. Cigna is acting like about 95% of employers that the PSG report says cover GLP-1 drugs for those with Type 2 diabetes.

“We regularly review our health benefits to ensure they remain sustainable, accessible, and aligned with the unique needs of our workforce,” Cigna said in a statement about its GLP-1 coverage move. “As availability has increased and new options have emerged, we’ve made the decision to end our plan’s coverage for GLP-1s for weight loss. We remain committed to supporting our employees’ health through a range of weight management programs and resources.”

Increasingly, employers are guiding their workers to the cash-paying market for GLP-1 drugs where prices have fallen in the last year. It’s not uncommon for oral pills or injectable dosages to be purchased for about $150 a month.

But it’s not just cost that is figuring into employer and health plan decisions not to cover GLP-1 drugs.

The PSG report said “high discontinuation rates are now playing a major role in coverage decisions, as nearly two-thirds of patients without type 2 diabetes who take GLP-1s discontinue treatment within one year.” In addition, 72% of those surveyed indicated that “discontinuation rates and weight regain were at least moderately influential in their GLP-1 coverage decisions.”

“Discontinuation rates are very high and employers want to know if this will actually provide a return on their investment if they (workers) aren’t taking them long-term,” Lee said in an interview.