Employer costs for health benefits in the private sector rose six percent in the 12 months to June 2026 - more than double the 3.1 percent growth in wages and salaries over the same period, according to the Bureau of Labor Statistics (BLS) Employment Cost Index.

Paul Pruitt, founder of SHARx, a specialty pharmacy cost management firm based in St. Louis, Missouri, and a former benefits broker with more than a decade of experience advising employers on group coverage, argues that most organizations are responding to rising costs in ways that will not work – and that the root cause lies not in the benefits plan itself, but in how leadership engages with it.

"If we focus on the cost of insurance, we're looking at the wrong problem," Pruitt told HRD. "The insurance price and what it costs is a function of how it's used, how your members access care. Those are the areas where meaningful impact can actually be made."

GLP-1s are a symptom, not the source

The temptation for HR leaders facing pressure from finance is to cut the most visible cost driver. Right now, that means GLP-1 medications. But Pruitt, who has worked in pharmacy benefit strategy since 2017, argues that removing or restricting GLP-1 coverage treats a symptom rather than a cause – and risks creating new problems.

"GLP-1s are exacerbating an existing problem, not creating a new one," he said. "Medication cost pressure has been building since the mid-2010s. The demand surge was predictable once GLP-1s were repurposed for weight loss."

Employers who cover GLP-1s without a structured program are compounding the problem rather than managing it, Pruitt says. The deeper issue is that obesity and type 2 diabetes share the same root causes in lifestyle, but the healthcare system addresses both primarily by masking symptoms rather than changing behavior.

Removing GLP-1 coverage without a plan risks signaling to employees, particularly those evaluating competing offers, that the organization is pulling back on health support. And GLP-1s will not be the last high-cost drug class HR teams are forced to reckon with. Sleep medications represent the next wave already building, according to Morgan Stanley Research, which projects orexin-based therapies could mirror GLP-1s' market trajectory and reach $16 billion by 2035.

"You can play whack-a-mole with GLP-1s, or the sleep thing, or whatever comes next," Pruitt said. "Or you can plan for it and address all of it more holistically. There's always going to be that next new thing we're freaked out about. We can either respond to it or we can plan for it."

Read the full article here: