What’s driving your GLP-1 spend — and how to get it under control

May 16, 2025
min reading

GLP-1 prescriptions are skyrocketing — and so are costs. The real drivers of GLP-1 spend aren't just who’s using them, but how. Learn how self-funded employers can control pharmacy spend without limiting access or outcomes.

Over the past two years, GLP-1 prescriptions have surged across the U.S. Thanks to the clinical effectiveness of medications like Wegovy, Zepbound, and Ozempic, employers are seeing more employees asking for coverage — and more plans adding them to their formularies.

But these medications aren’t cheap. GLP-1s typically cost $12,000–$16,000 per person per year. For self-funded employers, even 5–10% member participation can drive pharmacy costs up by 8–10% annually, according to IFEBP.

The real problem? Most of that spend is uncontrolled.

What’s really driving your GLP-1 costs

The true cost of GLP-1s doesn’t just come from who’s using them — it comes from how they’re being used. Here are the biggest cost drivers:

1. Max-dose prescribing by default

Most GLP-1 programs escalate members to the highest dose available, whether they need it or not. Higher doses mean higher costs and more side effects — leading to dropout and waste.

2. No dose management strategy

Without clinical oversight, many members stay on high doses longer than necessary. This inflates cost and reduces adherence.

3. Lack of behavior change support

GLP-1s reduce appetite — but they don’t teach lasting habits. Without structured coaching, most members regain weight after stopping the drug, restarting the cycle (and the cost).

4. No offboarding plan

Many programs don’t include a tapering strategy. That means members stay on indefinitely — even if they’ve met their goals.

5. No employer visibility

If you can’t see who’s using what, at what dose, and with what outcome — you can’t manage spend or prove ROI.

A smarter model: cost control without compromising outcomes

At Embla, we help employers reduce GLP-1 spend without limiting access. Our model combines:

  • Lowest effective dose protocols — start low and escalate only if needed
  • 1:1 video coaching rooted in Acceptance & Commitment Therapy (ACT)
  • Tapering support for members who hit goals or plateau
  • Data visibility so you know what’s working — and what’s not

This approach delivers:

  • 16.7% average weight loss in 12 months
  • 66% lower average GLP-1 usage
  • 8 in 10 members offboarded successfully without weight regain

5 ways to get your GLP-1 costs under control

If you’re a self-funded employer or plan consultant, here’s how to take back control of your GLP-1 spend:

1. Implement lowest effective dose protocols

Avoid automatic escalation. Require clinical review before dose increases.

2. Require behavior change support

Pair GLP-1 access with high-touch coaching to reduce dropout and support long-term success.

3. Set a tapering policy

Build an exit strategy from day one. Plan for how members will transition off medication safely.

4. Track medication usage, not just enrollment

Measure dose levels, side effects, weight outcomes, and coaching engagement.

5. Partner with a vendor who can manage it for you

Choose a solution that handles clinical oversight, coaching, and reporting — not just prescription access.

Final thoughts: it’s not just what you cover — it’s how you manage it

You don’t need to say no to GLP-1s to control costs. You just need to rethink how they’re delivered.

With the right partner and structure, GLP-1s can deliver lasting weight loss and reduce long-term health risks — without draining your pharmacy budget.

Ready to explore smarter GLP-1 coverage?

Discover how you can offer world-class GLP-1 care without blowing your budget.
Talk to our team