{"id":526863,"date":"2026-06-09T20:44:21","date_gmt":"2026-06-09T20:44:21","guid":{"rendered":"https:\/\/www.europesays.com\/ie\/526863\/"},"modified":"2026-06-09T20:44:21","modified_gmt":"2026-06-09T20:44:21","slug":"trouble-ahead-for-glp-1-drugs-as-health-plans-stop-paying","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/ie\/526863\/","title":{"rendered":"Trouble Ahead For GLP-1 Drugs As Health Plans Stop Paying"},"content":{"rendered":"

\"Wegovy<\/p>\n

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)<\/p>\n

UCG\/Universal Images Group via Getty Images<\/p>\n

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 report.<\/a><\/p>\n

A survey of benefits executives at more than 235 employers, health plans and unions showed nearly half, or 49%, or firms who do not currently cover GLP-1s for obesity would \u201cnot do so at any price,\u201d Pharmaceutical Strategies Group 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 \u201cmoderately\u201d or \u201cvery concerned\u201d about the affordability of GLP-1 therapies for the plan. <\/p>\n

\u201cAs drug costs climb, payers are under pressure to re-evaluate benefit design and cost management strategies,\u201d said Morgan Lee, Vice President of Research and Marketing at PSG. \u201cThe debate around GLP-1 coverage<\/a> 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.\u201d <\/p>\n

Just last week, Cigna confirmed<\/a> it was no longer covering GLP-1 weight loss drugs for its own employees effective July 1. <\/p>\n

The change, however, doesn\u2019t impact coverage of the prescriptions for the treatment of type-2 diabetes. Cigna is acting like about 95 percent of employers that the PSG report says cover GLP-1 drugs for those with type-2 diabetes. <\/p>\n

\u201cWe regularly review our health benefits to ensure they remain sustainable, accessible, and aligned with the unique needs of our workforce,\u201d Cigna said in a statement about its GLP-1 coverage move. \u201cAs availability has increased and new options have emerged, we\u2019ve made the decision to end our plan\u2019s coverage for GLP-1s for weight loss. We remain committed to supporting our employees\u2019 health through a range of weight management programs and resources.\u201d<\/p>\n

Increasingly, employers are guiding their workers to cash-paying market<\/a> for GLP-1 drugs where prices have fallen in the last year. It\u2019s not uncommon for oral pills or injectable dosages to be purchased for about $150 a month. <\/p>\n

But it\u2019s not just cost that is figuring into employer and health plan decisions not to cover GLP-1 drugs.<\/p>\n

The PSG report said \u201chigh 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.\u201d In addition, 72% <\/strong>of those surveyed indicated that \u201cdiscontinuation rates and weight regain were at least moderately influential in their GLP-1 coverage decisions.\u201d <\/p>\n

\u201cDiscontinuation rates are very high and employers want to know if this will actually provide a return on their investment if they (workers) aren\u2019t taking them long-term,\u201d Lee said in an interview. <\/p>\n","protected":false},"excerpt":{"rendered":"Photo Illustration of the new Wegovy semaglutide tablets with injectable prescription weight loss medicines, Ozempic, Victoza and Wegovy.…\n","protected":false},"author":2,"featured_media":526864,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_share_on_mastodon":"0"},"categories":[274],"tags":[100227,18,1950,135,19,17,462,2927,227378,5359,46210],"class_list":["post-526863","post","type-post","status-publish","format-standard","has-post-thumbnail","category-medication","tag-cigna","tag-eire","tag-glp-1","tag-health","tag-ie","tag-ireland","tag-medication","tag-ozempic","tag-pharmaceutical-strategies-group","tag-wegovy","tag-zepbound"],"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@ie\/116722104847500290","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/526863","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/comments?post=526863"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/526863\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media\/526864"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media?parent=526863"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/categories?post=526863"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/tags?post=526863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}