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Canada News.Net
2 days ago
- Business
- Canada News.Net
Weight-loss drug prices prompt rethink of US health benefits
NEW YORK CITY, New York: Rising spending on weight-loss and specialty drugs is prompting a majority of large U.S. employers to scale back health benefits in 2026, as budgets come under pressure, a new Mercer survey released on July 16 shows. Among companies with 500 or more employees, 51 percent said they plan to increase cost-sharing for workers in 2026 — such as by raising deductibles or out-of-pocket maximums — up from 45 percent who plan similar increases in 2025. Soaring costs of GLP-1 weight-loss drugs, such as Wegovy, are at the heart of employer concerns. According to Mercer, 77 percent of employers now rank Wegovy as a top cost concern. "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. While some companies initially offered coverage for GLP-1 drugs in hopes of lowering long-term health costs tied to obesity, surging prices are causing second thoughts. "Some employers facing big cost increases in 2026 may feel this coverage is out of reach," Fluno said. Competition from new drugs in the coming years may give pharmacy benefit managers (PBMs) more leverage to negotiate lower prices. The current GLP-1 drugs list costs over US$1,000 per month, though many insured patients pay less. The Mercer report says prescription drug costs jumped eight percent last year, and overall health benefit costs are expected to rise 5.8 percent in 2025. Employers are also rethinking their relationships with PBMs — middlemen between drugmakers and insurers — amid concerns over transparency and pricing practices. Thirty-four percent are considering switching PBMs, and 40 percent are exploring alternative drug pricing models. The scrutiny follows regulatory criticism of major PBMs like CVS Caremark, Express Scripts, and Optum Rx for steering patients toward high-cost drugs — a claim the industry denies. This week, CalPERS, one of the nation's largest public healthcare purchasers, announced it would switch PBMs in 2026, citing the need for better oversight and transparency.
India Today
4 days ago
- Business
- India Today
US employers to cut health benefits amid soaring weight-loss drug costs: Survey
More than half of large US employers are planning to scale back healthcare benefits in 2026, as rising costs — driven largely by expensive weight-loss and speciality drugs — strain corporate budgets, according to a new survey by consulting firm survey, released on Wednesday, found that 51 per cent of companies with 500 or more employees intend to increase cost-sharing, such as higher deductibles and out-of-pocket maximums --- that's a notable jump from the 45 per cent of employers who said they would take similar measures for dramatic rise in popularity — and cost—of GLP-1 weight-loss drugs like Novo Nordisk's Wegovy has become a key pressure point, 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 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 Wegovy and Eli Lilly's Zepbound are listed at USD 1086 and USD 1059, respectively, but many patients pay less through their health to the survey, prescription drug costs jumped 8% last year. Mercer has forecast a 5.8 per cent rise in overall health benefit costs for 2025. Employers are also eyeing alternatives to traditional pharmacy benefit managers (PBMs), according to such as CVS Caremark, Cigna's 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 say they take an undisclosed cut of the discounts they receive rather than sharing them with patients and survey found 40 per cent 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.- EndsWith inputs from Reuters
Time of India
5 days ago
- Health
- Time of India
Many US employers plan to pare health benefits as weight-loss spending soars
New York: 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 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 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 the wholesale price that retail pharmacies pay for them. 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 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.
Reuters
5 days ago
- Business
- Reuters
As weight-loss spending soars, US employers plan to pare health benefits
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 ( opens new tab 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.N), opens new tab 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 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 the wholesale price that retail pharmacies pay for them. 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 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.
Straits Times
5 days ago
- Business
- Straits Times
Many US employers plan to cut back on healthcare benefits as weight-loss spending soars
Find out what's new on ST website and app. Concern over the cost of GLP-1 weight-loss drugs like Novo Nordisk's Wegovy has surged, with 77 per cent of employers surveyed naming them a top issue. NEW YORK - More than half of large US employers plan to scale back healthcare benefits next year as rising costs from weight-loss and speciality drugs squeeze budgets, according to a new survey released by consulting firm Mercer on July 16 . Among employers with 500 or more workers, 51 per cent 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 per cent 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 per cent 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 Ms 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,' Ms Fluno said. Greater competition in the weight-loss drug market in the coming years will give pharmacy benefit managers more negotiating power with drugmakers and drive meaningful cost reductions, said Ms Fluno. Top stories Swipe. Select. Stay informed. Singapore Over 600 Telegram groups in Singapore selling, advertising vapes removed by HSA Singapore Strong argument for cockpit video recording, says Iata chief in wake of Air India crash report Singapore Here comes the sun: Less rain, more warm days in second half of July Asia Former deputy minister seen as surprise front runner for Malaysia's next Chief Justice: Sources Singapore Baby died after mum took abortion pills and gave birth in toilet; coroner records an open verdict Business Tycoon Robert Kuok's daughter Kuok Hui Kwong appointed CEO of Shangri-La Asia Singapore Acute psychiatry services to be expanded across all healthcare clusters: MOH Singapore New network links Home Team psychologists, mental health bodies to boost emergency response Novo's Wegovy and Eli Lilly's Zepbound are listed at US$1,086 (S$1,395) and US$1,059, respectively, but many patients pay less through their health plans. Prescription drug costs jumped 8 per cent last year, according to the survey. Mercer has forecast a 5.8 per cent 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 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 fuelling interest in new models and emerging PBMs, with 34 per cent of employers considering a switch. The survey found that 40 per cent of employers are considering alternative contracting models for their prescription medicine benefits, such as those that price drugs based on the wholesale price that retail pharmacies pay for them. Regulators have criticised the three largest pharmacy benefit managers for steering patients towards more expensive drugs and inflating prices to generate revenue gains, an accusation that the industry denies. Reuters
