Best’s Commentary: Health Insurers Evaluating Balance Between Pharmacy Costs and Long-Term Value of GLP-1 Therapies

SEPTEMBER 22, 2026 10:18 AM (EDT)

Best's Commentary: Health Insurers Evaluating Balance Between Pharmacy Costs and Long-Term Value of GLP-1 Therapies

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OLDWICK - SEPTEMBER 22, 2026 10:18 AM (EDT)
As pharmacy cost trends continue to rise and clinical evidence evolves, health insurers face a fundamental question on whether improvements in long-term morbidity and the potential for improved mortality outcomes ultimately justify significant investments in GLP-1 therapies, according to a new AM Best commentary.

The Best's Commentary, "GLP-1 Therapies: Evaluating the Balance Between Pharmacy Costs and Long-Term Value," states that GLP-1 therapies have become one of the most significant drivers of pharmacy spending across the health care industry. Growing evidence supports improved morbidity outcomes and more-effective chronic disease management, which may reduce future medical costs. However, affordability pressures continue to shape health insurance coverage decisions, as GLP-1s remain a significant driver of pharmacy spending and long-term cost offsets remain uncertain.

"Discussion surrounding GLP-1 therapies has evolved well beyond weight loss," said Joseph Zazzera, director, AM Best. "The conversation now centers on whether the long-term health benefits justify the significant near-term pharmacy costs. Because GLP-1 therapies may require long-term treatment, they could continue to place upward pressure on pharmacy expenditures."

According to the commentary, the most immediate impact of GLP-1 therapies from a population health perspective is likely to be on morbidity rather than mortality. If positive outcomes seen from GLP-1 therapies can be sustained, the potential to reduce health care utilization, improve quality of life and lessen the long-term burden of chronic disease increases, which may reduce future medical costs. Whether improvements in morbidity ultimately translate into measurable reductions in mortality remains an important question.

The commentary also notes that most employer-sponsored health insurance does not cover GLP-1s for weight loss, so it is likely that many individuals are self-paying. Even with lower prices for some of the GLP-1 therapies, the magnitude of individuals who could be eligible for weight loss drugs has insurers and employers continuing to grapple with the affordability implications. Moreover, because members frequently change employers and health plans, the payer funding today's treatment may not be the organization that ultimately realizes tomorrow's medical savings benefit.

"Pharmacy costs are immediate and measurable, while many of the anticipated benefits-including fewer diabetes complications, reduced hospitalizations and improved management of obesity-related chronic diseases-may not be realized for years," said Zazzera. "GLP-1 therapies are likely to remain one of the industry's most closely watched developments, influencing pharmacy trends, employer and health plan benefit designs and long-term health care economics."

To access the full copy of this commentary, please visit http://www3.ambest.com/bestweek/purchase.asp?record_code=368973.