We're halfway through 2024, and cost trends are coming into focus. Here's what the data shows about healthcare cost trajectories.
The Numbers
Healthcare cost growth in 2024 is running at 6-7% for most employers—consistent with recent years but still elevated compared to pre-pandemic norms.
- What's driving costs:
- Specialty pharmacy, particularly GLP-1 medications
- Provider rate increases reflecting labor costs
- Utilization at or above pre-pandemic levels
- High-cost claimants driving tail risk
- What's providing relief:
- Telehealth reducing some unnecessary ED visits
- Better chronic disease management programs
- Biosimilar adoption (where available)
- Site-of-care optimization initiatives
Specialty Pharmacy Impact
Specialty drugs continue to dominate cost conversations:
- Representing 50%+ of pharmacy spend for many employers
- New high-cost therapies launching regularly
- GLP-1s creating an entirely new cost category
- Biosimilars offering savings but adoption is uneven
Managing specialty pharmacy is no longer optional—it's essential.
GLP-1 Reality Check
Employers who added GLP-1 coverage are seeing real impacts:
- Utilization growing faster than many projected
- Per-member costs significant ($12,000-$18,000 annually)
- Long-term adherence patterns still unclear
- Coverage decisions being revisited in some cases
The GLP-1 story is still being written.
Self-Funded vs. Fully-Insured
Experience differs by funding arrangement:
- Self-funded employers:
- Greater cost visibility
- More levers to manage costs
- Variable experience based on claims
- Stop-loss costs increasing
- Fully-insured employers:
- Renewals running 6-8% on average
- Less visibility into what's driving increases
- Dependent on carrier's book of business
- Some market variation by carrier and region
Looking to 2025
Early renewal indications suggest 2025 will see similar trends:
- Mid-to-high single-digit cost growth
- Continued specialty pharmacy pressure
- GLP-1 impact becoming clearer
- Mental health utilization increasing
Employers should plan for sustained cost pressure and develop proactive management strategies.
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