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ORLANDO, Fla. — SHRM members are shaking up their prescription drug benefits strategies thanks to cost increases that are driven in part by a massive uptake of weight loss medications, analysts for the HR organization said during its 2026 annual conference on Tuesday.
Specifically, GLP-1 drugs have become a “massive line item” for employers, said Kathryn Mayer, senior specialist, content at SHRM. The organization’s 2026 Employee Benefits Survey found that while close to half of the roughly 5,500 employer respondents covered GLP-1s for Type 2 diabetes management, only 15% did so for weight management.
“We’re finding that employers are struggling to fund GLPs,” said Calven Engstrom, a SHRM senior researcher. But given strong evidence of the drugs’ effectiveness and high demand from employees — a 2025 KFF poll found that 1 in 8 U.S. adults said they were currently taking a GLP-1 drug — organizations have to weigh competing interests.
“Many of these organizations are trying to balance employee health outcomes with the long-term affordability and sustainability of their typical health plan,” Engstrom said, adding that utilization rates for GLP-1s are probably among the most closely monitored by employers at the moment.
The results come less than a week after consulting firm Mercer announced that 6% of large employers dropped GLP-1 coverage this year, according to results from a recent survey.
SHRM’s findings on weight loss drug coverage also formed part of a broader observed shift in pharmaceutical coverage. Results showed a 16 percentage point year-over-year decrease in the share of employers that bundled prescription drug coverage with their health insurance, a decoupling that is likely tied to cost concerns. Relatedly, the use of third-party pharmacy management programs rose by five percentage points from 2025, SHRM said.
Unsustainable costs, particularly those tied to specialty pharmaceuticals, are driving employers to take a closer look at pharmacy benefit managers and become more deliberate about cost management, Mayer said.
A ‘course correction’ on mental health?
One of the more surprising results of this year’s survey concerned mental health. SHRM found that while the majority of employers offered mental health benefits, that share reached 82% this year, down six percentage points from 2025 and nine points from 2022.
“That’s not insignificant,” Engstrom said.
The sudden downward trend shouldn’t be too much of an alarm for employers, according to Mayer, but it may signal that organizations are rethinking their investments in mental health after a spike in offerings that occurred shortly after the COVID-19 pandemic.
“It was the biggest part of COVID in so many ways for benefits strategy,” Mayer said of the mental health benefits space, noting that growth of offerings like specialized counseling and mental health coverage may have duplicated existing medical or fringe benefits. “I think, possibly, it’s a course correction to fix some duplications, hold down some of those benefit line items and look at utilization.”
Hybrid work’s falloff continues, while menopause benefits, pet insurance surge
Fewer respondents said that flexible work benefits were “very important” or “extremely important” compared to 2025, SHRM said, and the share of those offering hybrid work options continued a downward trend dating back to 2022. Whereas 63% of employers offered hybrid work that year, 57% did so in 2026.
Meanwhile, menopause-specific employee benefits represented one of the highest-growth categories in SHRM’s survey, with 27% of respondents offering such benefits — up nine percentage points from 2025.
The growth of offerings in that space may reflect employers’ desire to offer more comprehensive packages that apply to multiple life stages, Mayer said. She noted the effects that menopause and perimenopause can have on metrics such as productivity, engagement and well-being.
Pet benefits also experienced a significant jump of five percentage points year over year, with 27% of employers offering them. The benefits are largely seen as a “win-win” for employers and employees, Mayer said, given that they are primarily paid by employees and generally entail securing a discounted rate for enrollees than they might otherwise find on the insurance market.
As part of the survey’s publication, SHRM noted that employers can use its interactive Employee Benefits Tool to dive deeper into the survey data based on factors such as organizational size, location and industry.