GLP-1 medications dominate the Canadian benefits conversation, but Aon Canada's Joseph Koo argues the more useful question concerns the whole drug plan and the workforce health strategy built around it. Statistics Canada's Canadian Health Measures Survey finds 68 percent of Canadian adults aged 18 to 79 are classified as overweight or obese, up from 60 percent before the pandemic. Koo's central point is that coverage philosophy matters more than any single drug class. Koo walks through plan design philosophy, prior authorization limits, data integration challenges, and the three steps HR leaders can take to align drug strategy with workforce health objectives.
GLP-1 medications now carry approved indications across type 2 diabetes, obesity, cardiovascular disease, kidney disease, and sleep apnea. A pipeline of new applications is set to broaden the category further. That reach makes them a workforce health decision, not a single line item. Joseph Koo, assistant vice president of health solutions at Aon Canada, says employers who get this right won't be the ones who cover the most or the least. "They'll be the ones who pair coverage with the right plan design and member support, turning drug spend into health outcomes. Not cost, but outcome end to end." The drug plan's overall philosophy matters more than any one molecule.
Aon's analysis of 50 million insured lives found a 44 percent reduction in major cardiovascular events among 140,000 GLP-1 users compared to non-users. Cardiovascular disease, obesity, and diabetes are the most common chronic conditions in a working-age population. Untreated obesity already costs Canada $27.6 billion annually in combined direct healthcare and indirect productivity losses, according to an Obesity Canada peer-reviewed study. Koo is clear that the long-term story is still being written, but the clinical breadth of this drug class is not a future-tense question. "The tipping point is already behind us. When a single therapy area covers that much ground, it stops being a line item. It becomes a workforce health decision."
Coverage is rising fast. The International Foundation of Employee Benefit Plans, July 2026 reports that 37 percent of Canadian employers now cover GLP-1 therapies for both diabetes and weight loss, up from 31 percent in 2025 and 17 percent in 2024. GLP-1 drugs accounted for an average of 11.1 percent of annual employer claims in 2026, per the same data. Canadian drug plan trend data shows semaglutide was the single largest drug expense on Canadian private plans in 2025, representing 6.1 percent of total drug spend. The category's share of plan budgets is not a projection. It is already here.
Plan sponsors should look at the drug plan as they would a financial risk portfolio. Where is exposure concentrated? What is the financial tolerance? Which plan design structures manage the extremes of outcomes? Koo says coverage decisions send a signal well beyond any individual drug. "An employer's approach here will tell current and prospective employees what they value in their workforce and how they go about promoting health within it," he says. "A gap, decisions not to cover certain drugs or conditions, will also tell those employees and prospects something." The philosophy has to hold up beyond the current hot topic.
Prior authorization helps. It does not do the whole job. "Prior authorization arguably does its job of getting the right drug to the right patient," Koo acknowledges. "However, prior authorization on its own doesn't control costs, and that's where plan design and financial risk thinking have to work together." Proactive member support is equally important once a drug is covered. Claims data shows members almost never book their own consultations. "The impact lives in reaching out to those members who are actually taking these drugs," Koo says. Passive tools do not move adherence. Insurers, carriers, and their provider networks must engage members directly.
Most employers cannot yet answer that question. Drug data, disability data, and absence data typically sit with different insurers in separate systems. Koo calls integration "the real maturity marker because employers cannot answer the questions that matter most, does GLP-1 coverage reduce absenteeism or affect disability experience, because the data doesn't meet." Member experience is equally undertracked. Prior authorization turnaround takes time, and renewal friction is real. "A plan can look really well managed on paper but still be failing the people using it," Koo explains. At Aon Canada, drug, disability, paramedical, dental, and financial well-being are assessed together, not as separate workstreams. HRD Canada's sponsored benefits reports cover related workforce health themes in depth.
Start with philosophy, then exposure, then reinvestment. First, define what the plan will support, based on what evidence, and for what purpose. GLP-1s are testing that philosophy today; other categories will test it tomorrow. Second, assess financial and human capital exposure at a portfolio level. Determine which plan design and funding mechanisms manage costs while generating the desired health outcomes. Third, decide in advance how potential savings will be used. "If employers reinvest into the supportive layer, adherence, coaching, benefit activation, health campaigns, mental health prevention, then arguably they make all the remaining drug dollars work harder," Koo says. "One aspect is a savings story. The other piece is an opportunity about the value of investment."
Joseph Koo: assistant vice president, health solutions, Aon Canada; pharmacist by training; career at the intersection of patient access and group benefits; provides pharmacy advisory to Aon's practice and its clients.