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Weight-loss drug costs are top concern for 77% of

employers

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Over half of large employers plan to increase cost-sharing

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Employers seek alternatives to pharmacy benefit managers

By Amina Niasse

NEW YORK, July 16 (Reuters) - More than half of large

U.S. employers plan to scale back healthcare benefits next year

as rising costs from weight-loss and specialty drugs squeeze

budgets, according to a new survey released by consulting firm

Mercer on Wednesday.

Among employers with 500 or more workers, 51% said they

planned to increase cost-sharing in 2026, including raising

deductibles and maximum out-of-pocket costs for workers. That is

up from 45% of large employers who said they would increase

cost-sharing for 2025.

Concern over the cost of GLP-1 weight-loss drugs like Novo

Nordisk's Wegovy has surged, with 77% of employers

naming them a top issue, the consultancy said.

"More clients are saying ... 'I don't know how much longer

we can sustain covering these medications'," said Alysha Fluno,

a pharmacy innovation leader at Mercer, in an interview.

While some employers have covered GLP-1s hoping for

long-term health savings, rising prices are forcing a rethink:

"Some employers facing big cost increases in 2026 may feel this

coverage is out of reach," Fluno said.

Greater competition in the weight-loss drug market in coming

years will give pharmacy benefit managers more negotiating power

with drugmakers and drive meaningful cost reductions, said

Fluno.

Novo's Wegovy and Eli Lilly's ( LLY ) Zepbound are listed at

$1086 and $1059, respectively, but many patients pay less

through their health plans.

Prescription drug costs jumped 8% last year, according to

the survey. Mercer has forecast a 5.8% rise in overall health

benefit costs for 2025.

Employers are also eyeing alternatives to traditional

pharmacy benefit managers (PBMs), according to Mercer.

PBMs such as CVS Caremark, Cigna's ( CI ) Express Scripts and

UnitedHealthcare's Optum Rx act as middlemen between drug

companies and consumers. They negotiate volume discounts and

fees with drug manufacturers on behalf of employers and health

plans, create lists of medications that are covered by

insurance, and reimburse pharmacies for prescriptions.

Drugmakers say they take an undisclosed cut of the discounts

they receive rather than sharing them with patients and payers.

Regulatory scrutiny and calls for transparency are fueling

interest in new models and emerging PBMs, with 34% of employers

considering a switch.

The survey found 40% of employers are considering

alternative contracting models for their prescription medicine

benefits, such as those that price drugs based on their cost to

the pharmacy.

Regulators have criticized the three largest pharmacy

benefit managers for steering patients toward more expensive

drugs and inflating prices to generate revenue gains, an

accusation that the industry denies.

California pension fund CalPERS, the second-largest public

purchaser of health benefits in the U.S., announced on Tuesday

that Caremark would replace UnitedHealth's ( UNH ) Optum Rx as the

fund's PBM in 2026. CalPERS said its five-year contract with

Caremark requires the PBM to boost transparency and oversight.