GLP-1s in Workforce Health: A Strategic Lever for Reducing Medical Costs in Europe
Executive Summary
Glucagon-like peptide-1 receptor agonists (GLP-1s), originally developed for Type 2 diabetes, are now at the forefront of obesity treatment. Recent U.S. studies show that GLP-1s can help employers reduce medical cost trends within 24 months, with implications that are gaining momentum across European markets. From a European employer perspective, GLP- 1s represent a strategic lever for preventing chronic disease, reducing absenteeism and presenteeism, improving employee retention, and enhancing workforce productivity and competitiveness.
This paper consolidates current medical, occupational, and economic data from the UK and EU to complement US-focused cost analyses in a multi-national context.
1. Health & Economic Burden
Obesity affects over 23% of UK adults and up to 28% in Germany.
OECD (2023): Obesity-related illness contributes to 7% of total EU healthcare expenditure (€110 billion/year).
RAND Europe (2023): Obesity is a top-3 driver of workforce-related health costs in France, Germany, and the UK.
IQVIA EU (2024): Forecasts €200M in employer healthcare savings if GLP-1s are adopted across eligible working-age adults.
OECD: Weight-related health conditions reduce productivity by up to 4% of GDP in some EU countries.
2. Medical Benefits Beyond Weight Loss
a) Cardiovascular Risk Reduction
SELECT Trial (NEJM, 2023): Semaglutide 2.4 mg led to a 20% reduction in MACE in adults with overweight/obesity and CVD (N=17,604).
b) Renal Protection
Meta-analysis (2024): GLP-1 RAs reduce risk of kidney failure by 16% and decline in kidney function by 22% (N=85,000+).
c) Cognitive Preservation
JAMA Neurology (2025): GLP-1 RAs reduce dementia risk by up to 45% in individuals with T2DM (N=164,000+).
3. Long-Term Adherence
Real-world data shows ~70% of patients discontinue GLP-1s within 24 months. Higher adherence seen with weekly regimens vs daily.
Early clinical benefit (HbA1c, weight loss) linked to sustained use. Gastrointestinal side effects are main cause of dropout.
4. Workforce Impact: Productivity & Retention
Scandinavian pilots: GLP-1 + coaching reduced absenteeism by 28% and presenteeism by 19%. (Study link: https://pubmed.ncbi.nlm.nih.gov/36927183/)
Retention improved by 13% among those in structured GLP-1 programs.
UK employers lose £554 per employee/year to obesity-related productivity loss. A targeted GLP-1 program could yield a 2–3x ROI within 3 years.
5. Strategic Opportunities for Employers
Targeted Risk Reduction: Prioritize employees with metabolic risk (T2DM, PCOS, hypertension).
Integrated Digital & Behavioural Support: Combine medication with coaching, nutrition, and tech support.
Access & Equity Controls: Avoid overtreatment by applying risk-based inclusion criteria.
6. Guidance for Employers Seeking Private Insurance Coverage
Business Case: Present productivity, retention, and healthcare cost metrics Target Age: 35–60 year olds with high chronic disease risk.
Occupational Health Role: Screening, adherence support, outcomes tracking
Monitoring: Track absenteeism, presenteeism, engagement, biometric outcomes
7. Reimbursement & Prescribing Comparison
UK
Criteria: BMI ≥35 + comorbidities; or BMI 30–34.9 with Tier 3 referral
Prescriber: Specialist (Tier 3/4)
Reimbursement Notes: NICE approved; NHS coverage via specialist services
France
Criteria: BMI ≥35 + comorbidities
Prescriber: Specialist
Reimbursement Notes: Limited reimbursement; strict eligibility
Germany
Criteria: BMI ≥35 + comorbidities
Prescriber: Specialist
Reimbursement Notes: Mostly private cover; limited public funding
Spain
Criteria: BMI ≥30 + comorbidities
Prescriber: Specialist
Reimbursement Notes: Regional variation in access and reimbursement
USA
Criteria: BMI ≥30 or ≥27 + comorbidities
Prescriber: Physician, NP, PA
Reimbursement Notes: FDA approved; coverage varies by insurer and state
8. Cost-Effectiveness Studies in UK & EU
UK: (Springer, 2023 ) Semaglutide more cost-effective than liraglutide (£280 savings/patient). Oral semaglutide saves £187/patient vs liraglutide.
Spain: Dulaglutide, semaglutide cost-effective vs insulin; favourable real-world outcomes.
France: GLP-1s reduced long-term chronic disease management costs in observational cohorts.
9. Call to Action
Employers should treat GLP-1s not as standalone pharmacological agents, but as cornerstones of chronic disease prevention strategies. Multinational HR and Occupational Health leaders must:
Set tiered eligibility
Implement ROI-based evaluation models
Embed digital health support
Advocate for insurer engagement and co-funding