Blue Cross Blue Shield of North Dakota (BCBSND) has announced changes to its coverage of weight-loss drugs, effective January 1, 2026. The decision comes amid rising use and costs associated with GLP-1 medications such as Wegovy, Saxenda, and Zepbound.
According to BCBSND, spending on these drugs increased by 46% in 2025. The organization estimates that total costs could reach $23 million for commercial plans. Studies cited by BCBSND have also raised questions about the long-term value and sustainability of these medications, which can cost more than $1,000 per month. Data from Prime Therapeutics shows that only 8% to 14% of people remained on their treatment plan after three years.
“GLP-1 weight-loss drugs, such as Wegovy, Saxenda and Zepbound, have gained attention and use across the nation to help people lose weight. While these drugs can be effective for some people, they also come with big challenges, including cost and consistent long-term use. In 2025, spending on these drugs increased by 46%. And we’re estimating that total costs can reach $23 million for commercial plans,” BCBSND stated in its announcement.
The new policy will affect fully insured large group plans (51 or more contracts), which will no longer cover weight-loss drugs—including GLP-1s and oral medications—starting with plan anniversaries in 2026. The company said this move is intended to help keep premiums stable and encourage drug manufacturers to improve pricing.
Self-funded plans will not be subject to the same restriction but must actively choose whether or not to include coverage for these medications. These clients may also opt to add programs like Vida Health for additional member support.
“Weight-loss drugs work best when combined with lifestyle changes. Programs like Vida Health and Omada offer coaching, digital tools and wellness support to help members develop healthy habits. Pairing these drugs and programs helps members lose weight in a way that lasts. It helps them stick to a treatment plan. It also lowers the risk of other health issues,” according to BCBSND.
The organization emphasized its commitment to providing high-quality and affordable health care while continuing investments in services that benefit all members.
“We are committed to making sure all our members get high-quality and affordable health care. By changing how we cover these drugs, we can keep investing in care that helps all members.”
BCBSND says it will work with members, employers, brokers, and providers throughout the transition process.
“We are here to help our members, employers, brokers and providers through this change. Together, we can make North Dakota healthier with new ideas, kindness and diligence.”
