Healthcare Costs To Increase Between 7-8% In 2025
Healthcare costs, and consequently employee benefit costs, have been growing at an alarming rate in recent years. Estimates show a similar growth in 2025 spending to 2024, marking years of compounding costs. As such, several industry surveys and reports reveal that employers anticipate healthcare costs to grow between 7 percent and 8 percent in 2025. For employees, that can mean higher premiums, deductibles, and copayments.
This article explores the key factors increasing healthcare costs in 2025.
Glucagon-like Peptide-1 (GLP-1) Drugs
GLP-1 use for weight loss is already widespread, but these costly medications are expected to grow in popularity. According to KFF data, around 1 in 8 Americans have already used a GLP-1 drug, while 6 percent are currently taking one. However, this number is projected to rise in the coming years. JP Morgan estimates that 9 percent of the U.S. population could be on GLP-1s by 2030.
GLP-1 medications typically cost around $1,000 per month. Many plans only cover GLP-1s for diabetes or won’t cover these prescriptions at all. These costly medications are intended to be taken in perpetuity to achieve their benefits. This means that GLP-1 users may experience health benefits but will be required to use these high-cost treatments on an ongoing basis.
Drug Cost Increases
Several commonly used drugs are expected to have price increases this year. Healthcare services company Vizient projects that drugs used to treat osteoporosis, cancer, atopic dermatitis, and Type 2 diabetes are expected to rise anywhere from 4 percent to 10 percent or more.
Cell and Gene Therapies (CGT)
Advanced treatments, such as CGT, are designed to treat conditions such as blood and lung cancer, sickle cell anemia, and spinal muscular atrophy. These therapies demonstrate significant medical advancement but come with a high price tag. Some may cost thousands of dollars per week; others can cost between $250,000 and $4.25 million for a single dose. Given the massive price tag, even if only a few plan participants use these expensive prescriptions, it can significantly raise healthcare spending.
Many of these treatments have recently been approved, and hundreds more are currently in clinical trials and could be available in the coming years. By 2025, it’s estimated that nearly 100,000 patients in the United States will be eligible for CGT, which could cost $25 billion.
Biologics
Specialty drugs, including biological drugs, are one of the fastest-growing categories of pharmacy spending. Biologics are medications made from living organisms, such as sugars, proteins, and DNA. They treat a range of conditions, such as cancer, psoriasis, rheumatoid arthritis, and inflammatory bowel diseases. Although these drugs are effective at treating complex health conditions, they carry a high cost.
Biosimilars are an emerging category of biological medications. These treatments are similar to a reference drug, which is an existing biologic that was previously approved by the U.S. Food and Drug Administration (FDA). For a biosimilar to be approved, there must be no meaningful differences in safety and effectiveness from the original biologic. Compared with original biologics, biosimilars are lower-cost drugs that allow for greater access to more patients. New biosimilars are gaining FDA approval and entering the market each year.
Health Care Labor Costs
The current supply of healthcare workers does not meet the growing demand for utilization. This shortage is due to rising healthcare demands, an aging population, retiring workforces, and insufficient talent entering the healthcare industry. When key players in the healthcare industry are required to spend more on labor, those expenses are often passed on to employers and users of the healthcare benefit: employees and their dependents.
Chronic Health Conditions
Around 90 percent of the U.S. healthcare spend is on people with chronic and mental health conditions. Chronic conditions include heart disease, stroke, cancer, diabetes, arthritis, and obesity. 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 years.
Aging Populations
The percentage of the U.S. population that is 65 or older continues to rise, with more than 55 million Americans older than 65. Estimates show that there will be almost 80 million people aged 65 and older in the United States by 2040. 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.
Summary
While you can’t necessarily control these driving factors, educating yourself as a healthcare consumer is one way to help manage healthcare costs. Start by fully understanding what your health plan does and doesn’t cover to help reduce your health care spending.
If you need additional help or insight into building and managing your company's benefits, reach out to The Siekmann Company today.
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