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Bank of America Proud of GLP-1 Spend
Estimated reading time: 7 minutes
In this week’s episode, Nick and Geoff dig into a single story with wide implications for every employer thinking about GLP-1 coverage. Bank of America CEO Brian Moynihan disclosed that the company spends $250 million annually on GLP-1 medications—one-eighth of its total healthcare spend—and called it a good investment. Nick and Geoff unpack what that means for employers of all sizes, why adoption has quietly plateaued at 36%, and why the direct-to-consumer market may be the most sustainable path forward for companies that can’t absorb full coverage.
Short on time? Here are the key takeaways:
- Bank of America spends $250 million annually on GLP-1s—one-eighth of its $2 billion total healthcare spend—making it the fastest-growing benefits category by a significant margin, up from effectively zero just four or five years ago
- Moynihan called it a good investment but acknowledged that access is gated through a health coaching program, a guardrail that reduces early dropout and creates accountability on both sides of the investment
- 29% of employees say they would switch employers to access GLP-1 coverage, making it one of the only pharmaceutical benefits with genuine recruitment power alongside salary and remote work flexibility
- GLP-1 employer adoption has plateaued at 36%, up only two percentage points from 2024, reflecting real hesitation among companies that haven’t yet covered it and quiet anxiety among those that have about cost trajectory and the difficulty of removing the benefit once offered
- The direct-to-consumer (D2C) subsidy model, where employers contribute a fixed monthly amount toward an employee’s own D2C purchase rather than covering the drug outright, may be the most practical and sustainable path forward for mid-size and smaller organizations, since D2C prices tend to decline as scale grows unlike employer-plan drug prices
Episode Summary
What Bank of America’s $250 Million Tells the Market
The Bank of America disclosure is notable not just for the dollar amount, but for what it signals at scale. Four or five years ago, GLP-1 spend at most major employers was effectively zero. Today it represents one-eighth of one of the largest corporate healthcare budgets in the country. That trajectory is unprecedented for a single drug category and reflects both the speed of clinical adoption and the depth of employee demand.
CEO Brian Moynihan’s characterization of it as a good investment is meaningful coming from someone running a company with the resources and data infrastructure to actually measure that claim at scale. However, there is an important caveat embedded in the same interview: Bank of America gates access. Employees are not simply prescribed the medication and reimbursed. There is a requirement—almost certainly a health coaching program—that employees must participate in to qualify for coverage. That guardrail serves two purposes: it filters for employees who are genuinely committed to behavior change alongside the medication, and it reduces the likelihood of the most common GLP-1 failure mode, stopping the drug before meaningful results are achieved.
More than 40% of people who start GLP-1 medications stop within a month, well before the 12-week mark where meaningful weight loss typically becomes visible. For employers covering the full cost of the drug, early dropout represents pure spend with no return. A gating requirement tied to coaching creates accountability on both sides and materially improves the odds that the investment pays off. Nick notes that the $250 million figure likely does not include the health coaching spend layered on top, meaning the true cost of Bank of America’s GLP-1 program is probably higher than the headline number suggests.
Employer Adoption Has Plateaued
Despite the Bank of America endorsement and the headline-grabbing talent attraction data, GLP-1 employer adoption has quietly stalled. A mid-year survey found that 36% of employers now offer GLP-1 coverage, up only two percentage points from 34% in 2024. The growth that felt explosive in the early years of GLP-1 commercial availability has flattened significantly.
Nick’s read of the market is that the companies currently covering GLP-1s are largely staying put, but they are not enthusiastic about the trend line. The cost is real, the drug is sticky, and the bell is hard to unring, meaning once you offer coverage, removing it triggers immediate employee backlash and recruitment disadvantage. The companies that have not yet extended coverage are watching that dynamic and likely hesitating. The ROI question is genuine: for employers with high turnover, the long-term health improvements that justify the spend may accrue to a different employer than the one paying for the drug.
Geoff frames the ROI challenge around the employee retention piece specifically. A 40-year-old employee who starts GLP-1 treatment today may not realize the cardiovascular and chronic disease benefits that reduce expensive claims until their 60s or 70s. If that employee is unlikely to remain at the same company for 25 to 30 years, the employer bears the cost without capturing the downstream benefit. That is the rational calculation that is keeping adoption flat, and it is a legitimate concern that Bank of America’s long-tenured workforce profile helps explain why they find the investment more compelling than a company with high annual turnover.
The Direct-to-Consumer Model May Be the Answer
A practically interesting part of the conversation is Nick’s argument for a direct-to-consumer subsidy model as an alternative to traditional employer coverage. The D2C GLP-1 market is growing rapidly. Novo Nordisk, Eli Lilly, and other manufacturers are building out consumer-facing channels that allow individuals to access the medications without going through employer plans, and prices in D2C markets tend to decline over time as competition and scale increase, which is the opposite of what typically happens with employer-plan-covered drugs.
For employers who want to support employee access without absorbing the full cost and complexity of plan-level coverage, the subsidy model offers a middle path. Instead of covering the drug as a benefit, the employer contributes a fixed monthly amount (e.g., $100 to $200) that employees can apply toward their own D2C purchase. Employees retain skin in the game, which research suggests improves adherence and reduces the early dropout problem. Employers maintain a predictable, capped cost that does not automatically grow with drug price increases. The overall accessibility of the medication improves without requiring a full benefits redesign.
Nick notes an open question around how industry surveys will eventually categorize the D2C subsidy model. Does an employer that offers a monthly GLP-1 subsidy count as an employer that covers GLP-1s? The answer matters for how the 36% adoption figure moves in coming years. Regardless of how it is counted, the D2C subsidy model appears likely to become the dominant approach for mid-size and smaller employers who cannot absorb the Bank of America-style full coverage model.
GLP-1s as the Underappreciated Story of the Decade
Nick closes with a perspective worth sitting with. Every new finding about GLP-1 medications seems to add to the positive column (e.g. reduced cancer metastasis risk, lower rates of alcohol consumption, reduced social media addiction and nicotine use, lower body weight reducing fuel consumption in aviation and transportation). There is a potential argument that a government-funded program to provide universal GLP-1 access would generate returns that dwarf the cost, across healthcare, transportation infrastructure, energy, and public safety.
Nick is careful to note he is not advocating for that specific policy outcome, but the breadth of the secondary benefits, emerging from a drug that only 11% of adults currently use, is striking. Geoff’s point is that AI is already used by the vast majority of adults in some form, yet GLP-1s—reaching only one in ten—are producing societal ripple effects that rival or exceed AI’s visible near-term impact. Nick’s argument that GLP-1s would be the story of the decade if AI were not consuming the entire news cycle is easy to make and hard to dismiss.
Frequently Asked Questions
Bank of America spends approximately $250 million annually on GLP-1 medications, according to CEO Brian Moynihan’s disclosure in a CNBC interview. That figure represents one-eighth of the company’s total $2 billion annual healthcare spend and reflects growth from effectively zero just four or five years ago, making it the fastest-growing category in their benefits portfolio.
No. Bank of America gates access, almost certainly through a required health coaching program. Employees must participate in a qualifying program to be covered for GLP-1 medications. That requirement serves both as a filter for genuine commitment and as a mechanism to reduce early dropout, which affects more than 40% of GLP-1 users within the first month.
A mid-year survey found that 36% of employers now offer GLP-1 coverage, up only two percentage points from 34% in 2024. The plateau reflects two competing pressures. Companies already offering coverage are largely staying put but anxious about rising costs and the difficulty of removing the benefit once it has been offered. Companies that have not yet extended coverage are hesitating because the ROI calculation is genuinely uncertain for employers with high turnover, since the long-term health benefits may accrue after an employee has moved to a different company.
Rather than covering GLP-1 medications through an employer health plan, some companies are exploring a model where they provide a fixed monthly contribution — perhaps $100 to $200 — that employees can apply toward their own direct-to-consumer purchase of the medication. D2C prices tend to decline over time as competition grows, unlike employer-plan drug prices which typically increase. This approach gives employees skin in the game, maintains a predictable employer cost, and extends access without requiring a full benefits redesign.
Yes, based on survey data. The 2026 NFP US Benefit Trends Report found that 29% of employees would switch employers to access GLP-1 coverage, placing it alongside salary and remote work flexibility as one of the few benefits with genuine talent switching power. Nick notes it is probably the only pharmaceutical benefit that has ever appeared on that list.
Only 11% of US adults currently use GLP-1 medications, yet the secondary effects are already showing up across healthcare, transportation, consumer behavior, and public safety. Every new research finding seems to add to the positive column, from reduced cancer metastasis risk to lower rates of social media addiction and alcohol consumption. Nick’s argument is that if AI were not consuming the entire news cycle, GLP-1s would be the defining technology story of the decade, and that their near-term societal impact may exceed AI’s visible effects even at current penetration levels.
Full Episode Transcript
Nick: Welcome to the Wellable Weekly Podcast, where we talk about key topics and trends at the intersection of wellbeing, technology, and HR. I’m Nick, along with my good friend and co-host Geoff. Geoff, how’s it going?
Geoff: It’s going great, Nick. Another wonderful summer day here.
Nick: It’s coming near the end of summer. It’s August, so before you know it, it’s September, then fall, then New England winters. I can’t believe how quickly it’s happening. So this episode, we’re covering one article and one topic that we said not long ago we were shocked we don’t talk about more frequently: GLP-1s.
We have a short clip from CNBC featuring Bank of America CEO Brian Moynihan. They were discussing financial markets and there was a segment specifically about GLP-1s and Bank of America employees. What he said was striking: they spend $250 million a year on GLP-1s. For context, Bank of America has hundreds of thousands of employees and spends about $2 billion a year on healthcare overall. Four or five years ago, that GLP-1 number was near zero. So it goes from zero to $250 million — an incredible amount of growth, unquestionably the biggest growth of any healthcare spend category. And it makes up one-eighth of their total healthcare spend today. My guess is that number is still increasing.
Geoff: The number jumps off the page because of the size and scale of Bank of America, but it’s not an outlier. This growth trajectory for GLP-1 spending has accelerated significantly over the past couple of years, going from a niche drug that folks were starting to test to basically a wonder drug having widespread impact on all parts of society. There are different estimates, but certainly north of $100 billion in total GLP-1 spend in 2026, and it’s probably the biggest contributor to some estimates that overall pharma spending will eclipse one trillion dollars this year for the first time. The question Brian Moynihan addresses directly in the clip is whether it’s a good investment. That’s the question a lot of employers are grappling with — is it a good investment for all companies, or just for certain organizations given their size, scale, and how long they retain employees?
Nick: He said it’s a good investment, but if you peel back the onion a little, he also said we gate access to the drugs. He recognizes the cost is significant. I don’t think he mentioned it in the interview, but I looked it up — I believe the gating process for Bank of America is health coaching. To get covered for GLP-1 drugs, you have to go through some type of health coaching program and presumably stay enrolled. So it’s not unlimited open-ended coverage. And I wonder if that $250 million includes the health coaching spend on top of it. My guess is not, which means the true program cost is probably higher. But that gating feature signals that even enthusiastic adopters like Bank of America want some accountability built in. At the end of the day, Moynihan was asked whether benefits ever accrue back to the company, and he gave the honest answer: if someone’s 40 years old and uses GLP-1s from 40 to 70, but the benefit we get accrues in their 70s, odds are that person is no longer our employee. But his response was essentially what we often hear in the wellness industry: it’s the right thing to do. And doing the right thing has tangible market benefits. We’ve seen countless surveys of employees saying they would leave their current employer to access GLP-1 coverage. That’s how important this drug is to people.
Geoff: The question of whether GLP-1s are effective is not really up for debate anymore. The real question is who should be footing the bill. There are near-term advantages for employees who start taking GLP-1s — they may feel better day to day, lose weight relatively quickly, and by keeping that weight off long-term they may be less likely to experience a cardiovascular event that would be a difficult and expensive outcome for both the employee and their employer. The contrarian employer view is: that’s all well and good, but given our turnover rate, there’s a limited chance we’ll actually see positive ROI if we’re measuring healthcare spend against drug coverage cost. You might help someone get onto a good trajectory today, but if they leave the company during the years when they’d be most likely to have an event, you don’t capture the payoff. At the same time, the immediate recruitment benefit is real. The NFP 2026 US Benefit Trends Report found that 29% of employees would switch employers to access GLP-1 benefits. That’s a real talent attraction advantage.
Nick: That’s a third of employees. Outside of salary, I can’t think of another benefit that would get a third of employees willing to switch companies. Maybe remote work, but the list is very short. And GLP-1 is probably the only pharmaceutical drug on that list. Bank of America may be unique in terms of viewing it so enthusiastically and not seeming reluctant to spend more. But at the market level, GLP-1 adoption has kind of plateaued. A mid-year survey this year found that 36% of employers offer GLP-1 coverage — up only two percentage points from 34% in 2024, and essentially flat from 2025. There’s significant hesitation among companies that don’t currently cover it, and among those that do, there’s a quiet anxiety about how to manage the cost trajectory. Once you offer it, it’s really hard to take it back. Employees expect it, it becomes a baseline, and removing it triggers backlash. That’s just how benefits work. The direct-to-consumer market may actually be the path forward here. Novo Nordisk, Eli Lilly, and others are doing significant D2C business, and D2C drugs tend to drop in price as scale grows — the opposite of employer-plan drugs. An employer subsidizing an employee’s direct purchase, maybe $100 to $200 a month toward a D2C purchase rather than covering the drug outright, might be the most sustainable middle path for mid-size employers who can’t absorb the Bank of America-scale program.
Geoff: The D2C model with some employer contribution makes sense as a model with legs for the longer term. Add some lifestyle programming alongside it — health coaching, nutrition support, strength-building guidance since GLP-1s are known to impact muscle maintenance — and you have a model that combines the drug’s effectiveness with the behavior change layer that improves adherence. More than 40% of people stop taking GLP-1s within a month, well before the 12-week mark where meaningful weight loss typically becomes visible. Employers who are subsidizing the cost and pairing it with coaching have a much better chance of seeing the investment pay off.
Nick: The other thing worth noting is that I’m not sure I’ve ever seen a pharmaceutical drug where virtually every new finding is positive. When new drugs come out, you hear about sleep disruption, irregular this or that, the long list of potential side effects in the advertisement. Everything new we learn about GLP-1s seems to be almost universally positive. Last week I read an article saying that people on GLP-1 drugs have a lower risk of cancer metastasizing. You also hear about reduced social media use, less smoking, less alcohol consumption. Everything — these side benefits are almost entirely positive. I recognize it’s relatively new to the market, but the track record so far is remarkable. And as an employer, if you’re not blocking social media on your network and employees are using it during the workday, there’s an argument that GLP-1s could reduce that in a way that offsets or even justifies the spend on their own.
Geoff: It really earns that wonder drug moniker. The United Airlines CEO comment comes to mind — by having passengers on GLP-1s and at lower average weight, you could save hundreds of millions of dollars on fuel just from that alone. The ripple effects transcend employer-only coverage into broader consumer and societal impact.
Nick: And if you go into the public policy world, there’s a not-insignificant group of public health economists advocating that the US government provide GLP-1 access universally, free of charge. Lower healthcare system costs, lower fuel consumption, less road wear from lower vehicle loads, less dependence on foreign oil, reduced alcoholism and its downstream consequences — the case is genuinely interesting. And that’s from a drug that only 11% of adults are currently using. If AI weren’t dominating the news cycle entirely, GLP-1s would be the most transformational story of the decade. There’s a real argument to be made that in the near term, we will see more visible societal impact from GLP-1s than from AI. I’m not certain of that, but it’s an easy case to make and it has serious legs.
Geoff: And that just goes to show the impact of something that only one in ten people are actively using. We’re living through both revolutions simultaneously. What a time. That seems like a good place to wrap up. Thanks as always, Nick, and thanks to all our listeners. You can catch Wellable Weekly on Apple Podcasts, Spotify, or wherever you get your podcasts, and be sure to subscribe to the Wellable Weekly newsletter for all the latest insights. Thank you.
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