By Ray A. Smith and Peter Loftus

Coverage for Ozempic and other drugs used for weight loss has fast become one of the most coveted workplace benefits -- so much so that companies say they can no longer afford to provide it.

With as many as one in eight American adults taking the pills or injectables now, big employers from Cigna to PricewaterhouseCoopers are dropping coverage of so-called GLP-1s in droves. Others, like Chevron, are making workers jump through extra hoops to get coverage -- and to ensure the drugs are used effectively -- such as requiring multiple weigh-ins a month, meal-tracking on apps or sessions with an online health coach.

More than a quarter of big companies say they are adding criteria this year or next, while 11% have dropped or are planning to drop coverage for weight-loss purposes altogether, according to soon-to-be released data from benefits-advisory firm Mercer.

Globally, the number of companies covering GLP-1s for weight loss has fallen to 23% this year from 30% in 2024, a new survey of more than 400 companies by the International Foundation of Employee Benefit Plans shows.

Under those circumstances, Samantha Stratton says she is just glad her employer's plan will still cover her Wegovy injections at all. She and her doctor lobbied to get her on the Novo Nordisk drug last year after the plan stopped covering the rival Zepbound shots she had been taking.

The approval, though, came with a catch: She must log her weight and meet with a nutritionist at least once a month via an app, something she didn't have to do when she was on Zepbound.

Still, "it's a small ask to avoid paying thousands out of pocket," says Stratton, who works in the work-life benefits industry and lives in West Haven, Conn. Plus, she thinks the structure has helped her stick to the regimen. She has lost 130 pounds since she began GLP-1 medications.

"Even just tasks like going up and down the stairs are so much easier now," she says.

The drugs aren't just a cost concern for employers. They have also become important tools for attracting and retaining staff. In a recent survey of more than 1,000 workers by insurance broker NFP, about 30% said they would switch jobs if that got them coverage for GLP-1 medications.

That is a big reason many companies extended coverage of the popular drugs to weight-loss use -- and not just diabetes treatment -- in the first place.

Wooing workers, though, has become less of a priority as companies' spending on GLP-1 drugs has ballooned. HCA Healthcare, which employs more than 300,000 workers across its hospitals and medical centers, stopped covering the drugs for weight-loss use as of January after use of GLP-1s on its employee plan surged 90% in 2025, driving up its costs. Like most companies, it still covers it for diabetes.

Blue Cross Blue Shield of Massachusetts has stopped coverage of GLP-1s for obesity treatment in the plans it sells to employers, too. As of January, employers can instead buy the coverage as an add-on, and 20% have opted to, says Amy McHugh, a spokeswoman for the Massachusetts insurer.

Had it done nothing, the Blue Cross Blue Shield insurer projects its GLP-1 costs would run close to $1 billion this year, nearly double its costs in 2025 and seven times the $140 million it spent in 2023. That "would mean significantly higher premiums for everyone, whether they use these medications or not," McHugh adds.

"We certainly hear a lot of angst about this," says Jeff Levin-Scherz, a senior managing director in health and benefits at WTW, formerly known as Willis Towers Watson.

Many of the benefits-consulting firm's clients are experiencing double-digit increases in medical and pharmacy costs, he says. "That's very hard to build into a budget, give people the salary increases they need because of inflation -- and run a profitable business."

Some employers and health economists maintain that paying for GLP-1s will ultimately pay off if slimmed-down workers stick around long enough for the potential savings to kick in from, say, avoiding or reversing obesity-related joint or heart issues. A growing body of research suggests the drugs have even broader health benefits -- such as helping to prevent or stall cancer -- that could trigger additional savings.

Soren Bjorn, chief executive of fresh berry supplier Driscoll's, said that calculus was a point of debate among executives at the Milken Institute Global Conference in Los Angeles last month. Those whose companies had leaned in to broader GLP-1 coverage for employees said that after 18 to 24 months, they had started to see overall healthcare costs come down, he said.

"So for our employees next year, it's going to be free," he said recently at The Wall Street Journal's Global Food Forum in Chicago.

Some research backs up the idea. Individuals who took a GLP-1 for 18 months saw slower medical cost growth and a reduction in hospitalizations, according to a January study published by Aon, which looked at the claims of 192,000 GLP-1 users who started the drugs between November 2021 and March 2025. Other studies suggest current prices for the drugs -- ranging from a $149 cash price to a list price of $1,350 a month, depending on the type, dosage and discount options -- still aren't cost-effective enough.

The leading manufacturers of GLP-1s, Eli Lilly and Novo Nordisk, have taken various steps to persuade more self-insured employers to cover the drugs. Lilly formed a team in 2023 to visit large employers and coalitions of employers that share tips on ways to control their healthcare spending.

Lilly also recently started a new service called Employer Connect that lets employers set up weight-loss drug coverage outside of traditional benefits. As part of it, Lilly sells Zepbound injection pens at a discounted price of $449 a month for all doses, and will soon start selling its weight-loss pill at $399 a month.

Yet overall commercial insurance coverage of GLP-1s for weight loss has stalled at roughly 50%, Lilly and Novo say.

Write to Ray A. Smith at Ray.Smith@wsj.com and Peter Loftus at Peter.Loftus@wsj.com

(END) Dow Jones Newswires

June 07, 2026 05:30 ET (09:30 GMT)

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