Most employers that were going to cover branded GLP-1 medications for obesity have made that decision. The action in 2026 is not more coverage. It is building management infrastructure around coverage that already exists.
That is the picture from the 2026 Pulse of the Purchaser survey, published by the National Alliance of Healthcare Purchaser Coalitions (National Alliance). The survey drew on 408 employer and purchaser responses fielded in May and June 2026 through National Alliance member coalitions. It is a non-probability sample of employers engaged through coalition membership.
Forty percent of employers in the survey currently cover branded GLP-1 medications for obesity, with 23 percent considering it. That combined 63 percent figure has been relatively stable since at least 2024.
Interest in expanding branded GLP-1 coverage is not accelerating. What is accelerating is how employers structure the benefit once they offer it.
A GLP-1 point-solution vendor is a third-party program that manages employer-sponsored access to GLP-1 medications. These programs typically cover eligibility screening, prior authorization, prescription oversight, lifestyle coaching, and adherence support. They sit between the employer plan and the prescriber, adding a management layer that neither the PBM nor the insurer typically provides on its own.
The share of employers using a point-solution vendor to manage GLP-1 access rose from 11 percent in 2024 to 28 percent in 2026, according to the National Alliance survey. Another 39 percent are considering one.
The 17-percentage-point increase was the only GLP-1 strategy to show a statistically meaningful gain in the survey. No other item in the set changed over the same period.
Coverage and management are moving at different speeds. Among employers that currently cover or are considering branded GLP-1s, 83 percent are using or considering a point-solution vendor. Among employers not covering branded GLP-1s, the rate is 29 percent. That gap points to how closely the two decisions travel together for employers that have committed to covering these drugs.
The December 2025 Peterson Health Technology Institute (PHTI) report on employer GLP-1 strategies described a market where the question has shifted from whether to cover the drugs to how to keep utilization financially sustainable. PHTI identified three management phases: initiation (who qualifies), maintenance (keeping patients on treatment), and discontinuation (managing patients who stop). Most employer programs were still developing protocols for all three, the report found.
The cost pressure that is pushing employers toward structured management is documented across multiple data sources. Plans covering GLP-1s for obesity recorded a prescription drug trend of 18.3 percent in 2025, with 8.8 percentage points directly attributable to GLP-1s, according to Segal's SHAPE data. Plans that did not cover GLP-1s for obesity recorded a prescription drug trend of 10.5 percent.
The KFF 2025 Employer Health Benefits Survey found that 19 percent of employers with 200 or more workers covered GLP-1 drugs for weight loss in 2025. Among those with 5,000 or more workers, the rate was 43 percent. Larger employers also tend to have more infrastructure to manage the benefit once offered.
Compounded GLP-1 medications received the lowest employer interest of any obesity strategy in the National Alliance survey. One in four employers (25 percent) currently covers compounded products, but 52 percent are not considering coverage. That compares with 37 percent not considering branded GLP-1 coverage and 10 percent not considering lifestyle programs.
The low interest in compounded products is consistent with regulatory developments from 2025. The FDA removed semaglutide from its drug shortage list in February 2025, which ended the legal basis for widespread compounded semaglutide production.
Compounders were required to stop producing copies for most patients by a subsequent FDA deadline. Employers that had informally tolerated members using compounded GLP-1s through pharmacy benefit carve-outs now have less flexibility to maintain that approach.
Nine in ten employers in the National Alliance survey currently offer or are considering lifestyle programs such as exercise and nutrition support. Sixty-eight percent limit or are considering limiting GLP-1 access to specific populations such as those with clinical obesity diagnoses or documented comorbidities.
For a benefits broker, the most useful data point in the GLP-1 section of the survey may be the vendor pipeline. More than a third of employers (39 percent) is considering a point-solution vendor but has not yet engaged one. That is the largest consideration pipeline of any obesity strategy measured by the National Alliance.
It describes a client population that has recognized it needs more structure around GLP-1 management and has not yet decided how to get there. A broker who can help a plan sponsor evaluate vendor options and connect pricing to clinical protocols is working on a problem the employer has already identified as a priority.
