Employers are increasingly focused on GLP-1 costs as pharmacy spending continues to rise, according to Business Group on Health’s 2027 Employer Healthcare Strategy Survey. The survey, conducted in June, included 127 employers representing 11 million covered lives.
Here are seven things to know:
- Pharmacy accounts for 25% of total healthcare spending and is projected to rise 12% in 2026, driven by rapid growth in GLP-1 utilization, expansion of high-cost specialty drugs, broader treatment indications and the emergence of cell and gene therapies.
- Nearly all employers surveyed, 95%, said they were concerned or very concerned about pharmacy costs.
- Fewer employers are covering GLP-1s for weight management. Those that still are have grown more inclined to adopt stricter utilization management to curb inappropriate use.
- Employers are also turning to formulary design, coverage policies and clinical edits to steer patients toward lower-cost biosimilars when clinically appropriate.
- Direct-to-consumer and direct-to-employer channels are gaining traction for GLP-1s specifically. Sixteen percent of employers said they will direct employees to DTC channels for the drugs, while 17% will use DTE arrangements as an alternative to going through their PBM.
- Employers are also scrutinizing their PBM relationships more broadly. Thirty-two percent said they will offer transparent or new-generation PBM models in 2027, and another 47% are weighing the move for 2028-2029.
- The findings come as employers scrutinize healthcare spending more broadly. Median healthcare cost trends are projected at 8.5% in 2026 and 9.2% in 2027.
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