As weight-loss spending soars, US employers plan to pare health benefits
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 (NOVOb.CO), 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.
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Scottish Sun
a day ago
- Scottish Sun
I lost 8st in a YEAR on Mounjaro – I had to have an organ removed but I still went back on the jabs as soon as I could
Scroll to find out everything you need to know about fat jabs NO WEIGH! I lost 8st in a YEAR on Mounjaro – I had to have an organ removed but I still went back on the jabs as soon as I could Click to share on X/Twitter (Opens in new window) Click to share on Facebook (Opens in new window) A WOMAN has revealed how shedding a whopping 8st completely transformed her life but also landed her in a major surgery. The weight loss warrior, Em, has been documenting her transformation on her TikTok, @EmsJourney. Sign up for Scottish Sun newsletter Sign up 2 A woman lost 8st in a year on Mounjaro Credit: TikTok/ @emsjourney 2 She had to have major surgery but still went back on the jabs Credit: TikTok/ @emsjourney Despite the drama that followed, Em is still a massive fan of Mounjaro and says it's completely changed her life. Within months of starting, the weight was dropping off, her periods came back, and her PCOS, something she'd battled for years, finally started to settle down. But just as things were looking up, her journey took a painful turn. Only two months in, she was hit with a searing pain under her ribs that had her doubled over and rushing to A&E. Doctors ran tests and found a gallstone blocking her bile duct and it was causing mayhem inside her body. Her kidneys were struggling, inflammation was through the roof, and surgery quickly became the only option. By October, doctors told her she'd need her gallbladder removed. And while that sounds scary enough on its own, she was also midway through a course of GLP-1 medication. But her consultant gave her the green light to stay on the jab right up until a week before the op, saying it'd be safer for her to lose more weight before going under the knife. She said: 'Because I was still such a high weight, it made more sense to stay on it and make myself safer for surgery.' I lost 6st with fat jabs but ended up with 'Ozempic face' – I got youthful look back with six make-up tricks Post-op, she was back on the meds just two weeks later and didn't look back. She's since reached a peak dose of 15mg, and now she's tapering down, currently on 10mg. The results are impressive. Em has lost a jaw-dropping 8st in just 12 months. Her PCOS is under control, her cycle's back on track, and she's feeling better than ever. While the gallstone drama was a shock, she says the benefits far outweigh the risks. Experts say there's a very real link between GLP-1 weight-loss drugs like Mounjaro and gallbladder problems, especially gallstones and inflammation of the gallbladder. In fact, so many patients report it that the UK's Medicines and Healthcare products Regulatory Agency lists gallbladder issues as a known side effect of drugs like Mounjaro. Rapid weight loss, especially more than 1.5kg (3.3lbs) a week, increases your risk of developing gallstones. That's because your liver pumps out more cholesterol when you lose weight quickly, and that cholesterol can crystallise in your gallbladder. Combine that with the fact that GLP-1s slow down digestion, including how often the gallbladder empties, and you've got a recipe for trouble. So while these meds can deliver dramatic results, they're not without risks. Doctors often recommend regular scans or blood tests, and say anyone experiencing sharp pain in the upper right side of their tummy, nausea, or fever should get checked out urgently. Still, Em has no regrets. She says the gallbladder scare was a small price to pay for getting her life back. Fat jabs hitting shelves soon The so-called 'fat jab' revolution is officially under way and it could change the way Brits tackle weight loss for good. For the first time ever, family doctors across England are now dishing out the powerful new weight-loss injection Mounjaro, as part of a major NHS shake-up to fight obesity. The drug, which contains the active ingredient tirzepatide, is being dubbed the strongest slimming jab yet and more than three million people could be eligible to get it on prescription. It's a landmark move in the war on waistlines, with obesity levels in England more than doubling since the 90s. Until now, similar injections like Ozempic and Wegovy were mainly reserved for type 2 diabetics or available through pricey private clinics. But from now on, GPs will be encouraged to prescribe them to those at greatest risk — a move health bosses hope will slash sick days, boost the economy, and help cut rates of cancer, heart disease and dementia. Not everyone qualifies, though. Only those with the highest health risks are likely to get the green light. Everything you need to know about fat jabs Weight loss jabs are all the rage as studies and patient stories reveal they help people shed flab at almost unbelievable rates, as well as appearing to reduce the risk of serious diseases. Wegovy – a modified version of type 2 diabetes drug Ozempic – and Mounjaro are the leading weight loss injections used in the UK. Wegovy, real name semaglutide, has been used on the NHS for years while Mounjaro (tirzepatide) is a newer and more powerful addition to the market. Mounjaro accounts for most private prescriptions for weight loss and is set to join Wegovy as an NHS staple this year. How do they work? The jabs work by suppressing your appetite, making you eat less so your body burns fat for energy instead and you lose weight. They do this my mimicking a hormone called GLP-1, which signals to the brain when the stomach is full, so the drugs are officially called GLP-1 receptor agonists. They slow down digestion and increase insulin production, lowering blood sugar, which is why they were first developed to treat type 2 diabetes in which patients' sugar levels are too high. Can I get them? NHS prescriptions of weight loss drugs, mainly Wegovy and an older version called Saxenda (chemical name liraglutide), are controlled through specialist weight loss clinics. Typically a patient will have to have a body mass index (BMI) of 30 or higher, classifying them as medically obese, and also have a weight-related health condition such as high blood pressure. GPs generally do not prescribe the drugs for weight loss. Private prescribers offer the jabs, most commonly Mounjaro, to anyone who is obese (BMI of 30+) or overweight (BMI 25-30) with a weight-related health risk. Private pharmacies have been rapped for handing them out too easily and video calls or face-to-face appointments are now mandatory to check a patient is being truthful about their size and health. Are there any risks? Yes – side effects are common but most are relatively mild. Around half of people taking the drug experience gut issues, including sickness, bloating, acid reflux, constipation and diarrhoea. Dr Sarah Jarvis, GP and clinical consultant at said: 'One of the more uncommon side effects is severe acute pancreatitis, which is extremely painful and happens to one in 500 people.' Other uncommon side effects include altered taste, kidney problems, allergic reactions, gallbladder problems and hypoglycemia. Evidence has so far been inconclusive about whether the injections are damaging to patients' mental health. Figures obtained by The Sun show that, up to January 2025, 85 patient deaths in the UK were suspected to be linked to the medicines. Top priority will go to patients with a body mass index (BMI) of 40 or more or 37.5 for people from certain ethnic backgrounds and who have at least four obesity-linked health conditions. That includes things like high blood pressure, cholesterol, prediabetes, type 2 diabetes, sleep apnoea and heart disease. Doctors are also expected to check whether patients have first tried to lose weight through diet and exercise before offering the jab. Despite the huge hype, not all GPs will be able to hand them out and even if you qualify, you might be told to wait or referred to a specialist clinic instead. Experts are warning that while the jabs can be a game-changer, they're not a magic fix. Side effects can range from mild nausea to more serious complications, and not everyone will tolerate them well. And with demand through the roof, many Brits are turning to the private route. Of course, always remember that too-good-to-be-true prices, quick-check applications and zero aftercare are all major warning signs. Experts say if you are thinking about going private, do your homework and don't gamble with your health for a quick fix.
Daily Mail
a day ago
- Daily Mail
Man, 31, who lost 14 stone after Mounjaro helped him kick habit that caused his weight gain reveals odd side effect of jab
A super-slimmer was astounded when his local Chinese takeaway rang to see if he was 'still alive' after weight loss jabs helped him kick his egg fried rice addiction. Jordan Bateman, 31, from Swansea, weighed 28st when he decided to overhaul his lifestyle in July 2024. Mr Bateman, who works as an entertainment manager for a leading holiday park, also travels around the UK to work as a stand-in and as a drag queen. Being on the road so much was playing havoc with his waistline as he would binge on fast food at service stations on his way to gigs, and call his local takeaway to get his order ready when he was heading home. He said: 'This is so embarrassing, my local Chinese actually phoned my house to see if I was still alive. 'Before my weight-loss journey, I would be on the M4 after gigging all weekend and, on the drive home, I'd ring my local Chinese and say, "Can I have my order?" 'I wouldn't even need to say what I wanted, it would already be there. 'I'd typically go for lemon chicken, seaweed, egg fried rice, chips, prawn crackers and duck spring rolls.' But today he no longer salivates at the thought of a glistening platter of Chinese delicacies. He added: 'I could never eat any of that to that extent and that amount any more—in fact, I haven't had a Chinese for a whole year now.' With thousands of Britons now using GLP-1 medications such as Wegovy and Mounjaro to help them slim down, there's been a steady stream of side effects being shared and discussed by the jabber community. From chronic constipation to hair loss, loss of libido to extreme bloating, people have experienced all sorts, but prompting a welfare check from a local restaurant is definitely a first. Mr Bateman says he has spent more than £3,000 on Mounjaro prescriptions since last August, but it has paid for itself due to him eating less. He has also saved money on costumes, with his drag wardrobe now full of glitzy medium sized gowns rather than 4XL, which he needed to have tailor made. Growing up in Swansea, Mr Bateman was a 'highly active' child, always singing, dancing or acting. But after entering the entertainment industry aged 18, having studied performance and childcare at college, the demands of life on the road took a toll. He said: 'There's no kitchen when you're on the road, so my diet became all about what I could get at service stations – Greggs, McDonald's, that sort of thing. 'After a show, you'd go to the pub, then grab a pizza or a takeaway back at your digs. 'Everyone did it, so I didn't really notice how much weight I was gaining.' But Mr Bateman, who is 5ft 9in, was forced to admit his unhealthy habits had caught up with him when he found himself feeling 'breathless' while performing as his drag alter ego, Ruby Slippers. He visited his GP in July 2024 and was told he weighed 28st, which he said 'shocked' him, despite already understanding he was overweight—he had even appeared on Channel 4's How To Lose Weight Well. 'This time I knew it had to be different,' he explained. 'If I'd continued without a care in the world, I dread to think how heavy I would be now. 'I reckon in a year I'd have probably put another two stone or more on. 'I've probably added about 20 years on to my life expectancy – at 28 stone I was probably moments away from a heart attack or a stroke, and that for me is a massive life turnaround.' Mr Bateman initially considered a gastric sleeve but did not want to feel restricted in terms of what he could eat and, upon his GP's advice, opted for Mounjaro instead. The NHS says Tirzepatide, also called Mounjaro, is a weekly injection that patients do themselves, making them feel fuller for longer and, therefore, less hungry. It is advised that anyone taking the injection should eat a balanced, reduced-calorie diet and exercise regularly. Starting in August 2024, Jordan increased his injection dose monthly, before eventually tapering down due to nausea, upon advice from his jab provider, Numan. In total, Jordan estimates he has spent more than £3,000 on the medication but insists it has been 'worth every penny'. But he is keen to caution others that weight-loss jabs are not a shortcut. 'It's a commitment – you mentally and physically have to change what you do for it to work,' he explained. Jordan says his food shopping habits have 'completely changed' from lots of 'chocolate, crisps, lots of heavy carbs' with 'no colour' to fresh fruit and veg. He is also working with a personal trainer and following a nutrition plan as part of efforts to sustain his new lifestyle, so he can continue to live healthily after he stops taking the medication when he reaches his weight goal of 12st. Mr Bateman prepares his meals in advance, so that he does not have to resort to service station food while touring. While he says Ruby's character has always been 'confident' and 'larger than life' no matter his size, when performing as her lately, Jordan needs less of a break between sets and even does not mind 'having (his) arms out' on stage. Mr Bateman can also be more active when entertaining kids at the holiday park – and has noticed children draw him differently now, no longer representing him as a 'circle' but rather a typical 'stick figure'. And there's been another huge change triggered by the jab— Mr Bateman now feels 'empowered' to date for the first time in his life after feeling 'more confident' in his body. His friends, family and colleagues have all been complimentary about what he has achieved – but he admits his mind has not yet caught up. From not needing a plane seatbelt extender on a recent holiday to Tenerife, to having space between his stomach and the steering wheel when driving, the benefits of his transformation are manifold. 'I've still got a belly, however it's not as rounded and not as ghastly to look at,' he said. 'It was actually quite a relief to be able to walk around with confidence with my top off on holiday. 'Now I feel confident that I can walk into a theme park and go on to a rollercoaster and enjoy those weight-restricted activities without any kind of embarrassment.'
Scottish Sun
a day ago
- Scottish Sun
New link between ‘King Kong' of fat jabs and breast cancer, discovered – are you affected?
Click to share on X/Twitter (Opens in new window) Click to share on Facebook (Opens in new window) IT seems every week there's a new claim about what fat jabs can cure - beyond banishing that belly. The so-called skinny jabs - that were initially designed as treatment for type 2 diabetes, could lower the risk of breast cancer. Sign up for Scottish Sun newsletter Sign up 3 Mounjaro has been dubbed the 'King Kong' of fat jabs for its powerful weight-loss effects Credit: Getty 3 Scientists are exploring how this jab could help prevent cancer Credit: Getty Since exploding onto the weight loss scene, GLP-1 drugs have been found to come with extra beneficial side effects, according to various studies. They range from lowering the risk of heart disease, dementia, lung disease, depression as well as increasing libido and helping to combat addiction to booze and drugs. And now, scientists in the US have found another pro to the seemingly "miracle" drugs, specifially tirzepatide, the ingredient behind Mounjaro, may "significantly" slow the growth of breast cancer tumour. That said, the experiments were conducted on mice and so the experts cautioned further research was necessary to confirm their findings. The authors from the University of Michigan also didn't speculate on why the drug, nicknamed the 'King Kong' of all fat jabs for its effectiveness, might lower a patient's risk of cancer It comes as breakthrough research in May revealed that GLP-1s could help ward off up to dozens types of cancer, including breast. "While these are very preliminary results, they suggest that this new anti-obesity drug may also have a beneficial impact on breast cancer outcomes," study author, Amanda Kucinskas, said. For the study, researchers tracked 16 obese mice with breast cancer tumors, which were made obese by feeding them a high-fat diet starting at nine weeks old. When the mice reached 32 weeks, middle age for a mouse, they were split into two groups. One group received tirzepatide injections every other day for 16 weeks, while the other was given a placebo. Weight Loss Jabs - Pros vs Cons Throughout the treatment, the team monitored the mice's weight and tumor size twice weekly. Those treated with tirzepatide lost about 20 per cent of their body weight, mirroring weight loss seen in humans taking the drug Mounjaro over long periods. Additionally, these mice developed noticeably smaller tumors. The study highlighted a strong connection between reduced body weight and smaller tumors, with fat mass playing a key role in tumor growth. Most of the fat loss came from the body's main fat stores, which is called adipose tissue. What are the signs of breast cancer? BREAST cancer is the most common type of cancer in the UK. The majority of women who get it are over 50, but younger women and, in rare cases, men can also get breast cancer. If it's treated early enough, breast cancer can be prevented from spreading to other parts of the body. Breast cancer can have a number of symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue. Most breast lumps aren't cancerous, but it's always best to have them checked by your doctor. You should also speak to your GP if you notice any of the following: a change in the size or shape of one or both breasts discharge from either of your nipples (which may be streaked with blood) a lump or swelling in either of your armpits dimpling on the skin of your breasts a rash on or around your nipple a change in the appearance of your nipple, such as becoming sunken into your breast Source: NHS These findings were unveiled this week at ENDO 2025, the Endocrine Society's annual conference held in San Francisco. This research supports earlier findings shared at the American Society for Clinical Oncology (ASCO) conference in May, which suggested GLP-1 drugs might reduce the risk of 14 obesity-related cancers, including breast cancer, in diabetic patients. In that study, US researchers found that patients taking GLP-1 therapies had a 7 per cent lower chance of developing obesity-related cancers compared to those on DPP-4 inhibitors. When accounting for overall health benefits, the GLP-1 group was also 8 per cent less likely to die over a decade. 3
