As employers scale back coverage for GLP-1 weight-loss drugs, major retailers and pharmacy chains are expanding direct-to-consumer prescription programs to capture patients shifting to cash-pay options.
Walmart, Costco, Amazon and CVS are investing in programs that combine GLP-1 prescriptions with services such as weight management, nutrition coaching and home delivery. Amazon’s program offers eligible insured patients prescriptions starting at $25 a month, while Walmart has expanded its Better Care Services platform to include GLP-1 prescribing and digital support tools.
The shift comes as more employers stop covering GLP-1 therapies because of their cost, according to an Aug. 1 CNBC report. A recent Mercer survey found 6% of large employers dropped GLP-1 coverage this year, while the drugs’ share of claims increased to 11.4% from 6.9% in 2023. Cigna also recently stopped covering the medications for its own employees, the report said.
Industry experts told CNBC the trend is likely to favor large pharmacy chains while putting pressure on independent pharmacies, which generally do not participate in manufacturers’ direct-to-consumer programs. Some pharmacists also raised concerns that filling GLP-1 prescriptions through separate pharmacy networks could fragment medication records and make it more difficult to identify potential drug interactions.
Retailers have been racing to build out these access channels for months. Beyond its consumer weight-management program, Amazon Pharmacy has also expanded Zepbound access and added same-day delivery for Eli Lilly’s GLP-1 pill. CVS, Walmart and Sam’s Club joined the Medicare GLP-1 Bridge program in June, offering $50 copays and expanded pharmacist support for beneficiaries navigating the new coverage pathway.
The Cigna decision also follows a broader pattern of employers and health systems pulling back on coverage over the past two years. RWJBarnabas Health ended coverage for GLP-1s prescribed for weight loss under its employee health plan in 2024, citing adherence concerns, joining Fairview Health Services, Hennepin Healthcare, HealthPartners, Mayo Clinic and Ascension in trimming or dropping coverage. The dynamic has continued to strain health plan finances into 2026, a persistent dilemma that has intensified as Amazon and Walmart’s near-simultaneous program launches this spring signaled a broader shift toward retailers, payers and drugmakers competing directly for GLP-1 patients.
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