A New Approach for the GLP-1 Medication Cost Challenge

Open enrollment is here, and HR teams are staring down a tough reality: Rising drug costs are creating new challenges for HR, especially around GLP-1 medications. These once niche treatments have exploded into a top budget breaker, leaving HR to find practical ways to help employees keep their health – and their wallets – in check.

That pressure lands squarely on HR. Benefit leaders are fielding questions, juggling budgets, and working to clarify why plans look different this year. GLP-1 prescriptions will remain a focal point as open enrollment moves forward.

Against that backdrop, HealthEquity, the country’s largest HSA administrator, has introduced two new initiatives aimed at affordability. One connects HSA members with lower-cost healthcare options, starting with GLP-1 medications, and the other allows individuals to open and fund HSAs directly through a new digital enrollment tool. Both come as open enrollment kicks off, giving HR leaders new angles to meet employee demand for cost-effective care.

GLP-1 Medications Have Become a Line-Item Issue

Over the past year or so, GLP-1 drugs have shifted from clinical innovation to a major budget concern. They now represent nearly 7% of total drug costs, with some coalitions reporting that five GLP-1 medications alone account for 21% of all pharmacy spending. For HR teams managing plan renewals, this upends cost projections and adds a new budgeting variable.

What makes HealthEquity’s GLP-1 telehealth platform unique isn’t just access to care – it’s how it integrates treatment, prescription management, and payment. This is made possible through a partnership with licensed telehealth provider Agile Telehealth.

Employees with HealthEquity HSAs can book physician consultations, manage prescriptions, and pay with HSA funds. The entire experience takes place within the HealthEquity mobile app and via the web portal. This lets participants use pre-tax dollars for these costly medications without disrupting how they manage benefits.

The Bigger Picture: HSAs and Expanded Eligibility Support GLP-1 Affordability

Many employees paying for GLP-1s rely on HSAs to cover these drugs tax-free to lower out-of-pocket costs. Starting in 2026, the One Big Beautiful Bill Act expands HSA eligibility by making more Bronze and Catastrophic ACA plans HSA-qualified, increasing the eligible population by roughly seven million. 

“The intersection of regulatory change and economic pressure creates an unprecedented opportunity to help individuals and families build health savings while managing Bronze plan costs,” Dr. Steve Neeleman, HealthEquity Founder, said in a press release. “Our direct enrollment platform and new GLP-1 telehealth offerings are tailored solutions built around real consumer behaviors and preferences, optimized to deliver value exactly when and how Americans need it most.”

HealthEquity’s direct enrollment tool helps these new participants quickly open and fund HSAs through its mobile and web platforms, without needing employer involvement. This tool provides an additional way for employees to tap HSAs for GLP-1 and other healthcare costs as eligibility broadens.

For HR, this means a new wave of employees – many in households already balancing premiums, deductibles, and prescription costs – will qualify for HSAs for the first time. The direct enrollment tool is a potential complement to employer-sponsored accounts and can be framed as part of a broader financial wellness initiative to give employees more ways to build health savings.

Why This Matters for Open Enrollment Conversations

Open enrollment messaging often focuses on plan options, but affordability is the pressure point this year. GLP-1s highlight how rising costs directly affect employees. HR leaders can help employees manage out-of-pocket expenses by showing how HSAs cover prescriptions like GLP-1s.

For example, someone paying around $1,000 monthly for GLP-1 medication could save a few thousand dollars annually by using pre-tax HSA funds. This kind of tangible example can make open enrollment communications more relatable and actionable.

The takeaway: GLP-1s are just one cost driver – the real focus for HR is helping employees manage healthcare spending with the tools available. Open enrollment is when those conversations matter most.