Workforce-Focused Analysis on GLP-1s: Phase Two Findings

Workforce-Focused Analysis on GLP-1s: Phase Two Findings
January 13, 2026 12 mins

Workforce-Focused Analysis on GLP-1s: Phase Two Findings

Workforce-Focused Analysis on GLP-1s: Phase Two Findings

Explore second-phase GLP-1 study insights on improved medical cost growth, adherence and women’s health.

Introduction

Aon’s workforce-focused GLP-1 analysis was designed to help employers understand the long-term impact of covering second-generation GLP-1 medications – such as Mounjaro, Ozempic, Wegovy and Zepbound – for diabetes and weight management. Building on Aon’s initial analysis conducted in May 2025, the second phase of research expanded the study to include a larger, nationally representative sample of 192,000 GLP-1 users. To ensure robust comparisons, GLP-1 users were matched to non-users with similar demographic and clinical profiles, to create a control group of "digital twins".

The analysis leveraged de-identified commercial medical and pharmacy claims data from approximately 50 million commercial lives, allowing for a comprehensive evaluation of medical costs, clinical outcomes and adherence patterns over extended timeframes. This study is independent and agnostic to the specific drug, drug maker and insurance carrier or provider. The research is intended to provide employers with an independent longitudinal study to reference when making plan design, benefit and coverage decisions. 

Key Findings

Diabetes-related findings: Over a 30-month period, users of GLP-1s for diabetes experienced a slower increase in medical cost growth compared to non-users. The clinical benefits, including reductions to hospitalizations due to MACE continue to be observed in the second analysis.

Weight loss-related findings: Individuals using GLP-1s for 18 months show the same pattern of reduced medical cost growth, reductions in hospitalizations due to MACE and lower claims incidence for a range of conditions. 

Adherence: Adherence is a critical driver of value. GLP-1 users who maintain at least 80 percent adherence to therapy see greater cost reductions, and statistically significant decreases in MACE hospitalizations and condition incidence than those with lower adherence. 

Women’s health: Compared to men, women are more likely to benefit from GLP-1 therapy in reducing hospitalizations due to MACE, alcohol or drug abuse, bariatric surgery and pancreatic disorders. It is notable that a higher proportion of GLP-1 weight loss users are women, and we are observing additional promising impacts on a range of women's health conditions. Women GLP-1 users were observed to have lower incidence of ovarian cancer, breast cancer and osteoporosis than female non-users. Conversely, women GLP-1 users experience higher rates of hospitalization for gallbladder surgery than men.

Improved Medical Spend Growth: Weight Loss and Diabetes Cohort Findings

The second phase of analysis confirms and expands on earlier findings, showing that – following an initial increase – GLP-1 users in both the weight loss and diabetes cohorts experience slower medical cost growth  (medical and non-GLP-1 pharmacy spend) compared to non-users. 

Individuals using GLP-1s for diabetes experienced a six percentage point improvement in medical spend growth compared to the control group between 12 months and 30 months post GLP-1s initiation. Users with at least 80 percent adherence experienced a nine percentage point improvement compared to the control group. 

Users of GLP-1s indicated for weight loss experienced a three percentage point improvement compared to the control group between 12 months and 18 months post GLP-1s initiation. Users with at least 80 percent adherence experienced a seven percentage point improvement compared to the control group.

These results underscore the importance of adherence to GLP-1 drug therapy in observed decreases to cost growth over the study period. 

 

Medical and pharmacy claims cost for users of Mounjaro and Ozempic (treatment group) vs control over 30 months, compared to control group.

Mounjaro and Ozempic (treatment group) vs control over 30 months

Note: Rounds to nearest $10 and integer trends. Includes claims incurred Nov ’21 – Mar. ’25 (Paid through June ’25). Excludes users with <20% GLP-1 days supplied filed over time for which we can observe the individual. Does not factor in member cost share. Assumes flat 35% rebate on all pharmacy benefit brand medications.

 

Medical and pharmacy claims cost for users of Wegovy and Zepbound (treatment group) vs control over 18 months, compared to control group.

Mounjaro and Ozempic (treatment group) vs control over 30 months

Note: Rounds to nearest $10 and integer trends. Includes claims incurred Nov ’21 – Mar. ’25 (Paid through June ’25). Excludes users with <20% GLP-1 days supplied filed over time for which we can observe the individual. Does not factor in member cost share. Assumes flat 35% rebate on all pharmacy benefit brand medications.

 

Women’s Health Outcomes

In Aon’s study, GLP‑1 users experienced a 37 percent reduction in hospitalizations caused by MACE (including stroke, heart attack and heart failure) over the 24 months following GLP-1 therapy initiation. Women accounted for 63 percent of GLP-1 users in this study, and among female GLP-1 users Aon observed a 47 percent reduction in hospitalizations for MACE compared to the female control group. This represents a much larger reduction compared to the 26 percent reduction observed in male GLP-1 users compared to the male control group. This observed cardiovascular benefit carries a significant implication for employers, especially in workforce demographics with high cardiometabolic risk.

Beyond cardiovascular health, Aon observed that female GLP-1 users had an approximately 50 percent lower incidence rate for ovarian cancer and 14 percent lower incidence of breast cancer compared to matched female non-users. Furthermore, these women showed a 16 percent reduction in incidence of osteoporosis alongside lower rates of several other chronic conditions such as rheumatoid arthritis. Female GLP-1 users were also less likely to be hospitalized for alcohol or drug abuse, bariatric surgery, and certain pancreatic disorders compared to female non-users, with this reduction being relatively greater than that observed among male users. Conversely, female GLP‑1 users experienced higher rates of hospitalization for gallbladder surgery than male users.

Although claims data cannot establish direct causality, these consistent patterns suggest that GLP-1 therapy may offer health advantages for women, extending beyond weight management, glycemic control and traditional cardiovascular outcomes.

Diagnosis rate impact by condition among female GLP-1 utilizers of Mounjaro, Ozempic, Wegovy, and Zepbound during first 24 months compared to control

Condition Diagnosis rate impact Hazard Ratio
Breast Cancer Reduction 0.86
Ovarian Cancer Reduction 0.50
Rheumatoid arthritis Reduction 0.91
Osteoporosis Reduction 0.84

Note: All comparisons are at a 99% confidence interval

Inpatient admission by condition among female GLP-1 utilizers of Mounjaro, Ozempic, Wegovy, and Zepbound during first 24 months compared to control

Condition Inpatient admission impact Hazard Ratio
MACE Reduction 0.53
Alcohol or Drug Abuse Without Rehab Reduction 0.46 
Bariatric Surgery Reduction 0.21
Pancreatic Disorders Reduction 0.27
Gallbladder Surgery Increase 1.81

Note: All comparisons are at a 99% confidence interval

The Importance of Adherence

Across both diabetes and weight loss cohorts, adherence to GLP-1 therapy at 80% or higher amplifies cost benefits. The study also observed reductions in hospitalizations for MACE among highly adherent GLP-1 users. 

These findings indicate that much of the long-term value from GLP-1 therapy relies on members persisting with therapy with adherence rates above 80% to achieve the underlying clinical benefits. Recognizing the impact of GLP-1 adherence rates helps employers make informed decisions about coverage and support strategies for employees.

 

Medical and pharmacy claims cost for user of Mounjaro and Ozempic (treatment group) vs control over 30 months at 80% adherence, compared to control group.

Mounjaro and Ozempic (treatment group) vs control over 30 months at 80% adherence

Note: Rounds to nearest $10 and integer trends. Includes claims incurred Nov ’21 – Mar. ’25 (Paid through June ’25). Excludes users with <20% GLP-1 days supplied filed over time for which we can observe the individual. Does not factor in member cost share. Assumes flat 35% rebate on all pharmacy benefit brand medications.

 

Medical and pharmacy claims cost for user of Wegovy and Zepbound (treatment group) vs control over 18 months at 80% adherence, compared to control group.

Wegovy and Zepbound (treatment group) vs control over 18 months at 80% adherence

Note: Rounds to nearest $10 and integer trends. Includes claims incurred Nov ’21 – Mar. ’25 (Paid through June ’25). Excludes users with <20% GLP-1 days supplied filed over time for which we can observe the individual. Does not factor in member cost share. Assumes flat 35% rebate on all pharmacy benefit brand medications.

 

Future Outlook for GLP-1 Costs

Overall costs for GLP-1 users remain higher than those for non-users, largely due to the expense of the medication itself. However, employers are observing favorable medical cost growth reduction for users. Despite these positive shifts, total plan spending continues to exceed that of non-users when drug costs are factored in. It’s important to note that Aon’s analysis is based on retrospective GLP-1 pricing. Looking ahead, the drug pricing will continue to compress with direct-to-consumer programs, innovative pricing models and the approval of oral GLP-1 medications, all likely to influence market dynamics over the next few years.

Considerations for Employers

For employers, these results highlight that decisions about GLP-1 coverage extend beyond short-term drug expenses. Coverage decisions are complex, involving a multitude of factors with applicability that will vary by employer. Recognizing this, our analysis suggests that GLP-1 use with strong adherence is linked with improved employee health outcomes and a slower rise in medical costs over time, even as treatment costs continue to shift. Aon’s 2025 Health Survey saw that two-thirds of respondents are waiting for a higher cost threshold or remain uncertain about when to act. Adherence-related data empowers employers to make informed, nuanced decisions amid evolving pricing models and clinical developments.

Employers should consider that drug prices are likely to compress with expanded direct-to-consumer programs as well as the introduction of newly approved oral formulations, and should weigh clinical benefits and workforce needs among other factors.  There is no single approach to plan coverage for all employers but leveraging data and closely monitoring the emerging evidence and market landscape can help employers navigate complex coverage decisions.

Next Steps

Building on these results, Aon is continuing to track GLP-1 utilization, pricing and outcomes as new indications, products and financing models emerge. We are also exploring additional analyses focused on productivity and workforce performance, as well as opportunities to replicate this study among populations in several large countries outside the United States to better understand the global impact of GLP-1 medications.

Aon’s Thought Leaders
  • Farheen Dam
    Health Solutions Leader, North America
  • Doug Melton
    Head of Global Client Analytics, Human Capital
  • Laura Rissover
    Health Analytics, Human Capital
  • Todor Penev
    Head of Commercial Analytics, Health Solutions

 

About Aon’s Workforce Focused GLP-1 Analysis

Study Design and Data Sources

Aon’s GLP-1 analytics are built on deidentified commercial medical and pharmacy claims from multiple national data sets, representing approximately 50 million commercial lives. 

Key parameters of the second phase of analysis include:

Study period: GLP-1 initiations between November 2021 and March 2025, with paid claims observed through June 2025.

Population:

  • 192,000 GLP-1 users across all indications
  • 63 percent female; average age 49 years

Indications:

  • 70 percent primarily using GLP-1s for diabetes management
  • 30 percent primarily using them for weight loss
  • Medications analyzed: Second generation GLP-1s - Mounjaro, Ozempic, Wegovy and Zepbound were included in the analysis.

To ensure robust comparisons, GLP-1 users were matched to non-users with similar demographic and clinical profiles, including age, gender, baseline health care costs, diagnoses and prior use of relevant medications. Individuals without sufficient continuous enrollment, those who filled 90-day or less of a GLP-1, pregnant users and those with specific preexisting conditions were excluded. 

Pre‑existing conditions included (1) annual claims exceeding $500,000 in any year 2022–2024 and (2) blood disorders, end stage renal disease, cancer, or prior bariatric surgery during the 6‑month pre‑period before GLP‑1 initiation.

Adherence Measurement

Aon’s analysis uses proportion of days covered (PDC) as the primary adherence metric. In the broader multiyear trend analysis:

  • The average PDC among GLP-1 users is approximately 71 percent.
  • Half of users maintain over 80 percent adherence.
  • For the cumulative incidence and hospitalizations analyses, the study focuses on individuals with more than 80 percent adherence, allowing us to assess the outcomes of near continuous therapy.

PDC is calculated as (number of days covered) / (total days in the time period)

Cohorts and Time Horizons

The second phase of analysis extends and refines the original analysis by separating cohorts by primary indication:

  • Diabetes cohort: Individuals with a diabetes indication and GLP-1 use primarily for glycemic control
  • Weight loss cohort: Individuals using GLP-1s for obesity or weight management without a diabetes indication

Extending observation periods

  • 30-month analysis window for the diabetes cohort
  • 18-month analysis window for the weight loss cohort

This approach allows us to evaluate whether the cost and clinical trends seen in the first white paper persist over a longer timeframe and whether they hold consistently across key sub populations.

Aon’s analysis does not reflect:

  • The most recent direct-to-consumer pricing options
  • Newer strategies such as alternative payment methods, updated pricing agreements or emerging value-based approaches.
  • Non-commercially insured groups, such as individuals using compounded formulations, users without insurance or under Medicaid/Medicare.
  • Impact of new GLP-1 entrants, including anticipated oral formulations expected to enter the market in 2026, which may materially change price points and member experience.

As a result, the observed relationship between GLP-1 use and total cost in this study should be viewed as a baseline under past pricing conditions, not a forecast of future net cost.

Further reading on GLP-1s and cancer risk:

Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes (JAMA)
GLP-1 Receptor Agonists and Cancer Risk in Adults With Obesity (JAMA)

General Disclaimer

This document is not intended to address any specific situation or to provide legal, regulatory, financial, or other advice. While care has been taken in the production of this document, Aon does not warrant, represent or guarantee the accuracy, adequacy, completeness or fitness for any purpose of the document or any part of it and can accept no liability for any loss incurred in any way by any person who may rely on it. Any recipient shall be responsible for the use to which it puts this document. This document has been compiled using information available to us up to its date of publication and is subject to any qualifications made in the document.

Terms of Use

The contents herein may not be reproduced, reused, reprinted or redistributed without the expressed written consent of Aon, unless otherwise authorized by Aon. To use information contained herein, please write to our team.

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