Posted under: Business Owners, Employee Benefits, HBP, News
What the current evidence supports, and how Canadian business owners can fund access tax-efficiently
Ryan Ackers | SVP, Growth & Corporate Development, GBL
September 10th, 2026
GLP-1 receptor agonists arrived as type 2 diabetes therapies, and they remain highly effective at that job. But the evidence base has expanded well beyond glycemic control, and the class is now among the fastest-growing cost drivers on Canadian employer drug plans. GLP-1s represented roughly 25% of diabetes-related drug spend in 2021; by 2025 that share had climbed to nearly 57%.
For business owners this creates a practical question: employees are asking for access, and many owners want it themselves. How do you fund it without absorbing the cost into a fully insured drug plan and watching renewal rates follow? This article discusses GLP-1 Therapies and the Opportunity with Health Benefit Plans and Health Spending Accounts.
| Area | What the research currently shows | Strength of evidence |
| Type 2 diabetes | The original and best-established indication. Improved glycemic control, with Health Canada approval across the class. | Strong |
| Weight management | In SELECT, semaglutide produced a mean 10.2% weight reduction sustained to 208 weeks, versus 1.5% on placebo. Tirzepatide trials report larger reductions still. | Strong |
| Cardiovascular | SELECT (n = 17,604) found a 20% reduction in major adverse cardiovascular events in adults with obesity and established cardiovascular disease but without diabetes. | Strong |
| Kidney | The FLOW trial reported a 24% reduction in serious kidney outcomes, with all-cause mortality also reduced. | Strong |
| Inflammation | Meta-analyses show consistent reductions in CRP and TNF-α. Recent work reports statin-like reductions in hs-CRP. | Moderate – Unclear how much is a direct effect versus secondary to weight loss |
| Longevity | A 32-week trial (n = 108) found a 9% slower pace of biological aging on the DunedinPACE epigenetic clock. Trials with all-cause mortality as a primary endpoint are underway. | Preliminary – Signal only, not an established outcome |
Notably, cardiovascular benefit in SELECT was only partly explained by weight loss. Waist circumference change accounted for roughly a third of the effect, which has led researchers to reframe the class as disease-modifying rather than simply weight-loss agents.
Provincial plans generally reimburse GLP-1s only for the Health Canada–approved diabetes indication, not for weight management. Private coverage is inconsistent: roughly 31% of Canadian employer plans now include some GLP-1 weight-loss coverage, up sharply year over year but still a minority. Generic semaglutide reached the market in 2026 and near-term price reductions of 30–50% appear realistic, but expanded indications and rising utilization mean total plan spend is unlikely to decline. In the meantime, many Canadians holding a legitimate prescription are simply paying retail.
A Health Spending Account (HSA) is a self-insured Private Health Services Plan (PHSP) under the Income Tax Act. Employer contributions are deductible to the corporation, reimbursements are not a taxable benefit to the employee, and no CPP or EI applies.
Prescription drugs qualify as eligible medical expenses under paragraph 118.2(2)(n) where they meet a three-part test:
Prescribed GLP-1s dispensed through a Canadian pharmacy meet all three. Critically, the test turns on the prescription and the dispensing record, not on the indication. A GLP-1 prescribed for chronic weight management and recorded by a pharmacist is treated the same way as one prescribed for diabetes, even where the group drug plan would decline the claim.
The arithmetic is meaningful. An owner-manager in Alberta’s top marginal bracket funding $6,000 of annual therapy personally must first earn roughly $11,500 in salary to net it. Through a compliant HSA, that same $6,000 is a deductible corporate expense, reimbursed tax-free.
The Health Benefit Plan (HBP) offers the same benefits and follows the same rules as the HSA, but is self-adjudicated and typically much less expensive. It is generally a strong fit for companies with up to 20 employees, where the time needed for self-adjudication is considered to be reasonable.
The defining difference between GBL’s HBP and a standard HSA is the fee structure. Most HSAs operate on a “Cost-Plus” model, charging a 5%–10% administration fee on top of every dollar spent on medical care.
The HBP eliminates this. GBL charges a one-time setup fee, with zero recurring administration fees thereafter. The below cost comparison example illustrates the potential for cost-savings over a 5-year period through an HBP versus a HSA:
| Feature / Cost | GBL Health Benefit Plan (HBP) | Traditional HSA (Cost + 10%) |
| Fee Structure | One-time Setup Fee Only | No Setup Fee, 10% on all claims |
| Year 1 Costs | $2,000 | $1,000 |
| Year 2 Costs | $0 | $1,000 |
| Year 3 Costs | $0 | $1,000 |
| Year 4 Costs | $0 | $1,000 |
| Year 5 Costs | $0 | $1,000 |
| 5-Year Total Fees | $2,000 | $5,000 |
*Assumption: A company with $10,000 in annual medical expenses.
In this scenario, the HBP pays for itself within the first two years compared to an HSA.
Companies with annual medical expenses in excess of $10,000 will see even higher short and long term savings.
GLP-1s are shifting from a weight-loss story to a cardiometabolic one. Strong cardiovascular and renal evidence, a plausible anti-inflammatory mechanism, and an early but unproven longevity signal. Demand is not receding. For Canadian business owners, the HSA and HBP remain an underused and legitimately tax-efficient route to funding access.
GBL is a national Actuarial Consulting firm headquartered in Calgary. Since 1995, we have serviced plan sponsors and administrators and total rewards teams in navigating the complexities of employee retirement and health benefits. We are experts in pension plan consulting and administration, executive compensation strategies, and actuarial valuations.
GBL positions itself as a boutique alternative to large multinational firms, delivering senior-led actuarial expertise with personalized service and competitive pricing.
If you have questions about Health Benefit Plans reach out to us for a consultation by visiting www.gblinc.ca or reaching Ryan Ackers at 403.249.1820 or ryan.ackers@gblinc.ca.
Ryan Ackers is the SVP of Growth & Corporate Development at GBL, a national boutique actuarial consulting firm headquartered in Calgary, Alberta.
Provided for general information only; not medical, tax, or legal advice. Clinical decisions regarding GLP-1 therapy should be made with a qualified health care provider, and plan design and tax treatment confirmed with your advisors in light of your circumstances.
