GLP-1s Get the Headlines, But PT Delivers the Savings
Musculoskeletal (MSK) conditions — back pain, knee arthritis, shoulder injuries, and more — remain a top driver of employer healthcare spend. Now add in the surge of interest in GLP-1 drugs like tirzepatide (Mounjaro, Zepbound) and semaglutide (Ozempic, Wegovy). Even with manufacturers exploring lower-cost dosing and delivery, these medications still run $10,000–15,000 per patient per year.
These aren’t replacement costs. They stack on top of the already high MSK spending on surgeries, injections, imaging, and emergency department visits. According to RAND, nearly 12% of U.S. adults have used a GLP-1 — a big reason benefit managers are struggling to balance outcomes, budgets, and employee expectations.
Recent research suggests GLP-1s can be cost-effective, but that doesn’t automatically mean they save employers money. Here’s why — and how physical therapy (PT) fits into the picture.
The Cost-Effectiveness Lens
Cost-effectiveness is often measured with a research metric called the quality-adjusted life year (QALY). In simple terms: one year in perfect health equals 1 QALY; a year with pain or disability might equal 0.6. By multiplying the years gained with the quality of those years, researchers compare treatments not just by how long people live, but by how well they live.
The study also applied a $100,000 threshold — a common benchmark in healthcare. It means that if a drug, surgery, or therapy provides an extra year of perfect health, the cost should be $100,000 or less to be considered good value. If the cost is higher, the treatment may still help, but it’s harder to justify from a cost perspective.
The study concluded that tirzepatide provides greater health benefits at lower costs than semaglutide. Compared to diet and exercise, tirzepatide delivered gains at $57,400 per QALY, making it cost-effective by standard benchmarks. Interestingly, gastric bypass surgery dominated both drugs in eligible patients, with a cost of $30,700 per QALY versus sleeve gastrectomy.
But here’s the catch: QALYs measure health value, not employer ROI. For benefit managers, the timing of savings matters just as much as the clinical value.
Short-Term vs. Long-Term Savings
GLP-1s can deliver dramatic weight loss and improve cardiovascular health. Over the long term, that reduces risks for conditions like total knee replacement or heart disease.
For employers, though, those long-term wins may never be realized. In the short term, GLP-1s increase plan costs. And if an employee leaves before those savings accrue, the employer never captures the benefit.
That’s not to say covering GLP-1s has no upside. Employees want the benefit, and offering it can support recruitment and retention. But the return on investment is uncertain and often years away.
By contrast, PT delivers results employers can see right away.
How PT Delivers Immediate and Lasting Value
When an employee develops MSK pain, the cost escalation is fast: MRIs, specialist visits, ED trips, opioid prescriptions. Early access to PT disrupts that pattern.
Employers who implement PT-first strategies consistently report:
- Fewer unnecessary imaging and surgical referrals
- Lower medication use
- Faster return-to-work times
Those savings show up within the first year. At the same time, PT lowers downstream costs by preventing chronic pain and avoiding surgeries years down the road.
Examples from the research:
- Knee meniscus tears: PT achieves outcomes equal to surgery — even at 10-year follow-up.
- Rotator cuff tears: Many patients recover just as well with PT, avoiding surgical risks and costs.
- Low back pain: Early, guideline-adherent PT leads to better outcomes at a fraction of the cost. Some back surgeries can exceed $100,000.
The value doesn’t stop at claims data. PT improves quality of life — less pain, better function, and higher productivity. That translates into reduced absenteeism and higher employee satisfaction.
The Smarter MSK Investment
GLP-1s aren’t going away, and they play an important role in employee health. But when it comes to controlling MSK costs, physical therapy is the lever employers can pull right now. It saves money in the short term, prevents expensive interventions in the future, and boosts employee well-being along the way.
In a competitive talent market, benefits that improve quality of life aren’t just a health investment — they’re a recruiting tool. PT may not replace GLP-1s, but for sustainable MSK cost management, it’s one of the smartest investments employers can make.
Let’s talk about how PT-first strategies can fit into your benefits plan.
