- Key insight: Learn how employers can repackage benefits to sustain GLP‑1 access amid rising costs.
- Expert quote: Capped specialty accounts help preserve access while shifting budget responsibility, advises Alex Shubat.
- Supporting data: GLP‑1s cost employers $7,200–$10,800 per employee annually.
Source: Bullets generated by AI with editorial review
Millions of Americans now take GLP-1s, but with
Professional services firm PwC projects commercial healthcare costs will rise 9% in 2027, impacting GLP-1 affordability for many of the 1 in 8 adults health policy researcher KFF reports are taking them, as well as
"For a self-funded employer with 1,000 employees and a conservative 5% obesity-eligible utilization rate, that's 50 employees on GLP-1s, costing anywhere from $360,000 to $540,000 annually in
The drugs add "a significant cost to an already very difficult benefit budget situation," says Alex Shubat, co-founder and CEO of AI-powered employee benefits platform Espresa. The pressure is proving too much for some employers, with 10% planning to drop GLP-1 coverage in 2027, according to a recent survey from nonprofit Business Group on Health.
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At the same time, benefit leaders see the value of offering these medications and many are looking for a way to keep them — or begin offering them in the first place — in an effort to meet employee demand and achieve overall long-term healthcare savings, Shubat said.
One way to approach the challenge, he said, is to offer a lifestyle spending account (LSA) and add GLP-1 medication and support resources to the list of covered expenses. Espresa also offers a specialty care account benefit (SCA), dedicated specifically to areas like weight loss, hormone replacement, and mental health support. Unlike LSAs, SCAs are regulated because they are a healthcare benefit, and employers can offer up to $2,200 pretax, Shubat explained. They are designed to run alongside LSAs and other medical plans.
Both of these benefit options allow employers to apply a fixed allowance toward selected health and wellness expenses, helping them establish cost predictability while enabling employees to spend funds on what they value most.
"We are working with employers saying, 'Don't kill [GLP-1 access]. Offer the SCA, limit it to $2,200, and let the employees decide how they want to use those funds, because they will now go shopping and they'll find the best options," he said. "Hopefully the CHRO is happy, the CFO is happy, and the employee has something in their hands that they can use."
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Budget-friendly, holistic care
Shubat pointed out the importance of professional support alongside medication use, and that SCA funds are meant to cover both medications and follow-up care including medical advice, counseling and coaching. Similar to GLP-1 coverage through a standard health plan, employers offering a SCA can leave the benefit more open-ended or put barriers in place such as BMI ratio or diabetes diagnosis, he added. Offering both an LSA and SCA can be especially impactful, because more areas of health are being covered.
"[LSAs are more] preventative — you're going to the gym, you're getting a meditation app, you're taking care of your kids, you're seeing a financial advisor, you're taking care of those lifestyle things" Shubat said. "But when it comes time to actually see the doctor and get the meds, then the [SCA] program is what you're going to use."
Rather than view the addition of an LSA or SCA as yet another expense, Shubat encourages benefit leaders to look at the many single-point solutions they currently offer that could be covered under these umbrellas.
"We help companies extract the budget they're already using," he said. "Instead of offering benefits on a stand-alone basis, we'll help you roll them into an LSA. The majority of the time we're budget neutral."
