How to measure the long-term value of GLP-1s within employer healthcare costs

Employers are facing a difficult balancing act. GLP-1 medications offer significant opportunities to improve employee health, particularly for individuals living with obesity, diabetes and related chronic conditions. Yet their growing utilization is adding substantial costs to employer-sponsored health plans, often before the associated medical savings become apparent.

According to the Business Group on Health’s 2026 Employer Health Care Strategy Survey, nearly eight in 10 employers identified GLP-1 medications as a significant contributor to rising healthcare costs. While many recognize the potential clinical benefits, demonstrating a measurable financial return remains challenging.

For employers, the question is no longer simply whether these medications are effective. It is how to evaluate their value when pharmacy costs increase immediately, but improvements in medical utilization and health outcomes may take years to materialize.

Understanding the gap between costs and benefits

Traditional healthcare financial reporting emphasizes annual spending trends. GLP-1 therapies complicate that approach because their financial and clinical impacts follow different timelines.

An Aon analysis of approximately 192,000 GLP-1 users found that medical costs grew more slowly among individuals receiving these medications than among comparable nonusers.

For members with diabetes, medical cost growth was six percentage points lower over the period between 12 months and 30 months after treatment initiation. Among those using GLP-1s for weight loss, the improvement was three percentage points between months 12 and 18.

These findings highlight an important consideration for employers: evaluating GLP-1 coverage solely through first-year claims may capture the immediate pharmaceutical expense without recognizing the longer-term changes in medical utilization.

That doesn’t mean future savings are guaranteed. It means employers need a more comprehensive approach to measuring value.

The employer challenge: Managing both cost and continuity

Unlike health plans with relatively stable membership, employers must also account for workforce turnover when evaluating investments in chronic disease management.

An employee may begin GLP-1 therapy under one employer’s health plan but change jobs before the organization realizes any longer-term financial benefit.

This complicates ROI calculations, particularly when the treatment’s greatest potential benefits extend beyond a single benefit year.

Nevertheless, employers have compelling reasons to support effective chronic disease management. Improving employee health can reduce avoidable utilization, strengthen the overall health of the covered population and potentially improve productivity and workforce well-being.

The opportunity is to manage these therapies as part of a broader population health strategy rather than viewing them exclusively as a growing pharmacy expense.

Care management helps protect the investment

Approving GLP-1 coverage is only the beginning. Achieving meaningful clinical outcomes depends on whether employees can maintain therapy, manage side effects and receive appropriate ongoing support.

Aon’s research found that individuals maintaining at least 80% medication adherence experienced greater improvements in medical cost growth. Those improvements reached nine percentage points for diabetes and seven percentage points for weight loss compared with matched nonusers.

However, long-term adherence remains a challenge. Research from Prime Therapeutics, cited by Mercer, found that only approximately one in 12 members prescribed GLP-1s for obesity remained on therapy after three years.

Nurse-led care management coordinates the clinical and practical sides of GLP-1 therapy. Nurses educate members on use and side effects, coordinate between the member and provider if significant side effects are seen, and if the member stops GLP-1 use, the nurse assesses the why behind it and alerts the provider to look into alternative solutions. This coordination supports adherence, protecting the member’s health and the return the fund expects on its investment.

Look beyond total claims to measure performance

Employers need a clearer picture of how GLP-1 spending affects overall health plan performance.

That starts with analyzing incremental GLP-1 expenditures separately from other medical and pharmacy claims, while keeping those costs fully represented in total plan spending.

Alongside financial trends, employers should evaluate emergency department visits, avoidable hospitalizations, medication adherence and longer-term changes in diabetes and cardiovascular complications.

This dual perspective can reveal improvements in healthcare utilization that might otherwise be obscured by increasing pharmaceutical expenditures.

The need for this approach is growing. Mercer’s projected 2027 employer health benefit costs indicate that increasing GLP-1 utilization is expected to contribute approximately one percentage point to overall cost growth.

When a single medication category exerts that much influence on total spending, employers need greater visibility into the performance of their other healthcare investments.

Balance today’s financial pressure with tomorrow’s value

GLP-1 therapies represent a significant and ongoing financial commitment. Employers must continue evaluating coverage policies, utilization trends and affordability while recognizing that potential clinical and financial benefits may develop over several years.

The answer is not to discount rising pharmacy costs or assume that every investment will eventually generate savings. It is to measure short-term financial performance alongside longer-term health outcomes and the impact of coordinated care.

Employers that take this broader view will be better positioned to distinguish unavoidable cost pressures from opportunities to improve population health.

As GLP-1 utilization continues to grow, the organizations that make the most informed decisions will be those that measure not just the cost of treatment, but the value of helping employees achieve better health over time.