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Employers turn to HRAs to manage rising GLP-1 drug costs
Industry executives say carving GLP-1 coverage into a dedicated HRA can reduce what employers pay when PBM pricing becomes the highest cost component.
As US employers face surging pharmacy costs tied to GLP-1 weight-loss drugs, a growing number are turning to health reimbursement arrangements, or HRAs, as a cost-containment approach, Insurance Business reports.
Benefits industry executive Chris Byrd, of WEX, said carving GLP-1 medications out of employer drug plans and into a dedicated HRA is increasingly compelling financially, noting that PBM pricing has often become the highest price in the market.
Byrd pointed to retail and manufacturer support channels, such as Lilly Direct and programs, as well as pharmacy pricing sources like GoodRx, which he said can be lower than what PBMs charge employers when GLP-1s are included in the employer plan.
He also said that some large employers are restricting GLP-1 coverage for lifestyle use, including adding clinical prior authorization gates based on criteria such as type 2 diabetes diagnosis and specific BMI thresholds, including the Medicare-used threshold of BMI 35 and a BMI of 27 to 30 with comorbid conditions like hypertension or elevated cholesterol; separate polling cited by Insurance Business also finds 18 percent of adults have tried a GLP-1, and EBRI survey results released in summer 2026 show two-thirds of employees believe their employer should cover the drugs.