Spending on traditional medications – which are brand and generic non-specialty medications used to treat common health issues – has soared in the United States, surpassing the growth of specialty drug expenditures for the first time. This shift is primarily driven by the approval and increased use of GLP-1 (glucagon-like peptide-1) therapies for chronic weight management.
That’s a key finding of Evernorth’s new research, the 2025 Pharmacy in Focus report by Evernorth, which provides a deep dive into GLP-1 demand. “Historically, traditional drugs have maintained relatively stable costs,” said Ashley Holzworth-Nash, Vice President of Product Management at Evernorth. “However, the introduction of semaglutide for chronic weight management in 2021 has led to a significant increase in traditional drug spend.” According to the research, the annual growth rate of traditional drug spending increased from 2.1% in 2021 to 12.8% in 2024.
The influence of GLP-1s on weight management
A major factor behind this surge is the widespread adoption of GLP-1 therapies for weight loss. According to the report, medications targeting weight management accounted for 46.8% of the total increase in drug spending in 2024. GLP-1 therapies had a 210.2% increase in net trend in 2023, followed by a 148.7% increase in 2024.
A shift in diabetes treatment
GLP-1 therapies are also transforming diabetes treatment. The report notes a decline in the use of longstanding diabetes medications such as metformin and insulin, with a significant rise in the adoption of newer, high-cost treatments like GLP-1s and SGLT2 inhibitors.
“Clinical guidelines are increasingly favoring the use of GLP-1s earlier in diabetes management,” Holzworth-Nash explained. "This shift is driven by growing evidence of their benefits for related conditions, including cardiovascular and kidney diseases."
Implications for plan sponsors and patients
The rising use of GLP-1 therapies has implications for plan sponsors and patients. Nearly a third of commercially insured households reported using GLP-1s, primarily for weight loss, followed by diabetes management. Demand is expected to continue growing, with a projected 73.1% increase in utilization for weight loss by the end of 2025.
“Plan sponsors are experiencing ongoing pressures from relentless increases to traditional drug spend due to GLP-1 demand,” Holzworth-Nash said. “Without change, we can expect to see traditional drug spend continue to outpace specialty and overall drug expenditure increases leading to plan sponsors making tough decisions in regards to coverage. “
Financial challenges and coverage issues
As the demand for GLP-1 therapies continues to rise, employers and health plans are grappling with the financial implications. The report indicates that 59% of fully insured health plans cover GLP-1s for weight loss, while only 22% of employer-sponsored plans offer the same coverage. Plan sponsors cite financial barriers, uncertainty of long-term effectiveness and the lack of a clear return on investment as primary challenges.
“Employers and health plans need to carefully assess their coverage strategies,” Holzworth-Nash said. “Balancing the financial costs with the potential health benefits is crucial for making informed decisions.”
The increasing use of GLP-1 therapies is reshaping the landscape of traditional drug spending, with significant implications for patients, plan sponsors, and the health care industry. As these therapies continue to gain traction, ongoing research and strategic planning will be essential to navigate this evolving landscape.
As plan sponsors work to address their biggest concerns, it's critical for them to have a partner that anticipates, understands and innovates around their efforts. Download the full 2025 Pharmacy in Focus report on GLP-1s to see how Evernorth is partnering with plan sponsors to prepare for the pharmacy trends today and developing strategies to stay protected into the future.
This article was created with the assistance of AI tools. It was reviewed, edited, and fact-checked by Evernorth’s editorial team and subject matter experts.
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