Our latest Best Practices in Healthcare survey offers fresh insights into how employers are approaching coverage of GLP-1 therapies for weight loss. While full results will be released soon, early findings, combined with recent market developments, paint a clear picture of a rapidly shifting landscape:
- 57% of employers cover GLPs for weight loss (up 5% points from 2024)
- 15% of employers are either considering removing coverage (9%) or have done so in the past year (6%)
- Three-quarters (78%) would cover if costs were lower
These data points reflect growing interest, tempered by cost concerns, as employers weigh the value and sustainability of GLP-1 coverage. Meanwhile, the broader GLP-1 landscape continues to evolve across clinical, commercial and intellectual property fronts.
Novo Nordisk’s Wegovy® (semaglutide) received FDA approval for Metabolic Dysfunction-Associated Steatohepatitis (MASH), formerly known as NASH. This new indication applies to individuals with moderate to advanced liver fibrosis (stages F2 to F3) and marks the first GLP-1 therapy approved for liver disease. Notably, this approval isn't contingent on the presence of obesity or overweight. It joins Rezdiffra® as one of only two FDA-approved therapies for MASH, with Rezdiffra, a specialty drug, averaging $50K/year.
Oral semaglutide for weight loss coming in November
Oral semaglutide is currently available under the brand name Rybelsus® for diabetes. A new oral formulation for obesity is under FDA review, with expected approval in November 2025. If approved, it would be the first oral GLP-1 therapy for weight loss, potentially changing patient adherence and reshaping market dynamics. According to the pharmacy analytics company, IPD, costs may align with injectable GLPs, though gastrointestinal side effects may be more common due to the higher dosing requirements needed to produce oral tablets.
Canadian patent expiration will allow generic semaglutide in 2026
Novo Nordisk’s Canadian patent for semaglutide expired in 2020 due to non-payment of maintenance fees, invalidating a supplementary protection certificate that would have extended exclusivity to 2028. As a result, generic semaglutide is expected to launch in Canada in early 2026, with Sandoz and Apotex among the anticipated entrants. Companies like HIMS also plan to enter the Canadian market to capitalize on early generic availability.
Direct-to-consumer (DTC) update
Employers are increasingly exploring the DTC channel as they reevaluate GLP-1 coverage. Novo Nordisk recently introduced a $499 cash-pay option for Ozempic via its NovoCare platform, with similar pricing available through GoodRx. Both Novo Nordisk and Lilly are partnering with platforms like 9amHealth, Form, Goodpath, Teladoc and WW to offer weight-loss GLP-1s directly to consumers. In these models, members pay out-of-pocket while employers provide wraparound support programs.
As GLP-1 therapies expand into new indications and delivery formats, employers face complex decisions around coverage, cost and member experience. We will continue to monitor these developments and provide strategic guidance to help organizations navigate this fast-moving space.
