New Survey Data Reveals Rise of GLP-1 Drug Claims, With Utilization Management and Eligibility Requirements as Leading Cost-Control Mechanisms
A new survey report from the International Foundation of Employee Benefit Plans reveals updated U.S. employer coverage and claims representation surrounding glucagon-like peptide-1 (GLP-1) drugs. The International Foundation first conducted this survey in October 2023 and again in May 2024.
Employers indicated the following coverage for GLP-1 drugs:
- 55% provide coverage for diabetes only (down from 57% in 2024)
- 36% provide coverage for both diabetes and weight loss (up from 34% in 2024).
Of those currently offering GLP-1 drug coverage only for diabetes, 17% are considering offering the drugs for weight loss (down from 19% in 2024).
Percentage of Annual Claims
The average representation of GLP-1 drugs used for weight loss in total annual claims was 10.5% for 2025, an increase over the 2024 average of 8.9% and the 2023 average of 6.9%. Twenty-seven percent of employers reported GLP-1 drug costs to be more than 15% of their annual claims.
When I spoke to Julie Stich, CEBS, Vice President of Content at the International Foundation, she observed, “This new survey data shows that over the past two years, GLP-1 claims have continued to rise, reflecting a sustained interest in these drugs as both a weight loss and diabetes treatment. Organizations are balancing the ongoing demand from employees for GLP-1 coverage for weight loss by continuing to explore feasibility through cost-control mechanisms.”
Utilization Management
Of those covering GLP-1 drugs, 78% of employers are using utilization management as a cost-control mechanism. Out of those that use utilization management as a cost-control mechanism:
- 96% require prior authorization
- 26% require reauthorization for refills
- 14% use a physician-led approach
- 5% limit prescribers by type
- 3% limit prescribers to a telehealth/virtual care vendor.
Eligibility Requirements
Eligibility requirements, used by 68% of employers covering GLP-1 drugs, continue to be heavily relied upon as a cost-control option. The most prevalent eligibility requirements include:
- Minimum body mass index (BMI) (88%)
- Obesity with one other chronic disease (60%)
- Obesity and type 2 diabetes (34%)
- Obesity with two or more other chronic diseases (24%)
- Nutrition/dietary requirements (24%)
- Physical activity requirements (9%).
Visit www.ifebp.org/GLP2025 for more information and to view the full survey report.
