Health care costs are projected to increase substantially in 2025. According to industry surveys and reports, employers anticipate health care costs to increase between 7%-8% in 2025. As a result, employer-sponsored health care plans will continue to cost more per employee, impacting employers and employees alike.
Current factors leading to increased costs reflect inflationary pressures that have impacted health care since 2022. Medical inflation, rising pharmacy spending and increased demand for behavioral health care services are likely to continue the rising trajectory of health care spending.
Key Drivers of Cost Increases
As 2025 approaches, employers remain curious about what factors are driving these increases. Here are some key factors impacting rising health care costs in 2025:
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GLP-1 Drugs
Glucagon-like peptide-1 (GLP-1) drugs have gained widespread popularity due to their ability to allow patients to lose weight. Although initially approved as type 2 diabetes treatments, GLP-1 drugs, including Ozempic and Mounjaro, have been found to be effective for weight loss when paired with diet and exercise. These drugs are increasingly used by employer-sponsored health plans as a response to the impact of obesity, but they carry their own set of costs. GLP-1 medications typically cost at least $1,000 a month and must be taken in perpetuity to achieve their benefits. This means that GLP-1 users are required to use these high-cost treatments on an ongoing basis. With GLP-1s being used by more plan participants, they are one of the key drivers of rising health care costs.
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Specialty Medications
Drugs that fall under categories such as immunosuppressants, cell and gene therapies (CGT), biologics and antivirals are responsible for a significant portion of overall health care spend. According to a report published in the medical journal JAMA, biologics make up only 2% of prescriptions but account for 37% of net drug spending. Other specialty treatments, such as CGT, can carry an even greater cost. Some treatments may cost thousands of dollars per week; others can cost between $250,000 and $4.25 million for a single dose. By 2025, it’s estimated that nearly 100,000 patients in the United States will be eligible for CGT, which could cost $25 billion.
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Chronic Health Conditions
Around 90% of U.S. health care spend is for people with chronic and mental health conditions, according to the CDC. These chronic conditions include heart disease, stroke, cancer, diabetes, arthritis and obesity. An increasing percentage of the population has two or more chronic, high-cost diseases. In general, chronic disease is increasing in prevalence in the United States and is projected to continue to do so in 2025 and the upcoming decades.
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Aging Population
Life expectancy in the United States has increased significantly over the past 50 years; meanwhile, birth rates have trended down consistently. These factors contribute to a U.S. population with an average age that is slowly rising. In general, health care costs increase as people age. According to a report from the Centers for Medicare and Medicaid Services, per-person personal health care spending for the 65-and-older population is around five times higher than spending per child and almost 2.5 times the spending per working-age person.
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Health Care Labor Costs
Recent industry reports show that the current supply of health care workers does not meet the growing demand for utilization, largely driven by an aging population that requires more health care services. This shortage is expected to be due to factors like rising health care demands, an aging workforce and high rates of burnout.
Summary
Health care costs will likely rise significantly in 2025, but employers will take action to lower costs. Whether it’s standard cost mitigation strategies, such as cost sharing, or new initiatives to lower pharmacy costs, employers can consider which strategies can have a tangible impact on their health care spend. Pursuing the right initiatives can make a sizeable impact on an organization’s bottom line and the financial health of its employees. Rising health care costs may be unavoidable, but informed employers who enact proactive cost-reduction strategies will be better prepared for the changing health care landscape in 2025.
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