Efforts to reduce drug costs are underway at both the public and private levels. Still, the popularity of GLP-1 inhibitors like Ozempic and Wegovy appears to be a rapidly expanding cost center for health care finance leaders. In Brown & Brown’s inaugural employer health and benefits strategy survey, nearly 70% of the 760 employers surveyed said their health plans will now cover the cost of these heavily marketed medications.
While the survey does not distinguish between self-insured and fully insured employers, concerns about rising costs were widely reported. Many employers, with finance likely leading the decision-making process, are already implementing coverage restrictions or preparing for future plan changes to manage the financial impact.
The savings plan
Though employee benefits and rising health care costs are not new concerns for CFOs, the unprecedented demand and expense of GLP-1 medications, especially among younger employees, sets the stage for rising premiums or direct health plan expenses for self-funded employers. With this in mind, it’s unsurprising that nearly two-thirds (65%) of companies cited high-cost drug pipeline expenses as a top concern.
The ways companies are staying ahead of costs, at least to the best of their abilities, vary. Three-quarters (75%) are conducting audits across health plans to “uphold fiduciary responsibilities and ensure the integrity and compliance of their health plans.” Telehealth promotion is also a popular cost saver, with 70% actively making it a “fundamental component” of their employee health benefit programs, including in areas like primary care.
There are also efforts to reduce costs for services that are ongoing or have already been rendered. Eighty-one percent of companies are using request for proposal services to help negotiate pricing, control costs and meet fiduciary obligations for organizations operating self-insured health care plans.
GLP-1 restrictions and pharmacy benefits
Most employers (78%) have placed restrictions on GLP-1 coverage, but the growing concern over cost suggests more may be needed. The data supports this, with 85% of respondents saying they are considering additional restrictions for 2026 around GLP-1 coverage.
As employers look to contain pharmacy costs more broadly, many are tightening control over which drugs, not just GLP-1s, are covered and how. More than half (54%) have implemented or plan to implement a more restrictive formulary to manage costs. Among those, the most popular approach is a standard formulary, used by just over half (51%) of that group, which balances drug access with rebate optimization.
Well-being efforts
Though many non-medical well-being benefits have gone unused in recent years, employers continue to use them as a cost-conscious strategy to support employee wellness. For CFOs, this presents a challenge that requires balancing hard cost management with soft ROI expectations tied to human capital and talent retention. These are benefits that can be difficult to quantify and explain to other stakeholders, especially during cost-cutting efforts.
While most initiatives around well-being are still being led by a minority of companies, the efforts are worth noting. In regard to mental health, 44% of employers are looking to increase provider access, and 41% said they aim to improve the quality of mental and behavioral health offerings.
Fertility coverage is another area of growing interest. More than four in 10 (42%) organizations say they already partner with a family fertility vendor, and 20% of those who currently don’t are considering doing so next year. Paid parental leave above state requirements is also gaining traction, with 23% of respondents saying they offer enhanced leave in 2025, and more than half (54%) said they are expanding leave coverage for all employees this year.
