The news: One in five employers cover GLP-1 drugs for weight loss in 2025, with larger employers more likely to cover these medications, per KFF’s latest Employer Health Benefits survey.

Digging into the data: While all companies increased GLP-1 weight loss coverage (19% cover the drugs this year, up from 18% last year), large employers drove a substantial increase.

• At companies with 5,000 or more workers, 43% cover GLP-1s when used primarily for weight loss, up from 28% last year.
• 30% of mid-sized companies with 1,000 to 4,999 workers cover them, up from 24% last year.
• Only 16% of companies with 200 to 999 workers cover GLP-1 drugs for weight loss, which was the same percentage as last year.

Zooming out: Many companies believe that paying for GLP-1s is a valuable benefit for their workers.

• At smaller companies with 200 to 4,999 workers, 59% of those that cover GLP-1s for weight loss say it’s very important or important for employee satisfaction. Among smaller companies that don’t cover them, 46% say the same.
• At the larger companies, 86% of those that cover the drugs for weight loss agree it’s important or very important to employee satisfaction. Among larger companies that don’t, 48% say the same.

Yes, but: GLP-1 weight loss drug use exceeded expectations at all KFF-surveyed companies.

• 59% of the largest 5,000+ employee businesses reported higher-than-anticipated benefit uptake.
• At companies with 1,000 to 4,999 employees, 44% reported stronger than anticipated use, while 12% of companies with 200 to 999 employees say employee use of GLP-1s for weight loss was greater than anticipated.

Why it matters: US obesity rates are high, but GLP-1 drugs are expensive for employer health plans.

• 42% of adults under age 65 with private insurance could be eligible for GLP-1 drugs for weight loss, per KFF analysis in September 2024
• But the two approved GLP-1s for weight loss, Wegovy and Zepbound, cost around $1,000 per month without discounts.
• 66% of companies with 5,000 or more employees and 43% of companies with 1,000 to 4,999 employees said covering the drugs had a significant effect on their health plan’s prescription drug spending.

Our take: The widening gap in GLP-1 coverage between large and mid-sized employers highlights a growing benefits divide. Larger companies are absorbing weight loss drug costs as a retention strategy, while smaller firms less likely to cover them may risk losing talent to competitors that do offer coverage. Almost one-third (30%) of Americans would change jobs to get GLP-1 weight loss drug coverage, per a 9amHealth study published in January.

The significant year-over-year (YoY) jump in GLP-1 coverage among the largest companies signals a key shift: the employer debate is moving from whether to cover weight loss drugs to how to do so sustainably.

For employers to manage costs and improve employee results, consider:

• Adopting utilization management like requiring prior authorization to access GLP-1s for weight loss.
• Requiring employees to try alternative (and cheaper) therapies first.
• Limiting quantities to one month at a time.

For pharma marketers, consider:

• Leaning into stronger return-on-investment messaging like cost-benefit analysis storytelling to all employers.
• Offering evidence-based support programs for workers, and link GLP-1 use to lower long-term healthcare costs.