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High trend levels continue, with data showing sustained medical and pharmacy cost pressure
2025 Medical and pharmacy trend (year-over-year cost increase) has remained elevated at 7.7%, after stabilizing at a high level of 8% the year prior. Employers should prepare for ongoing health plan cost pressures in this new environment of higher trend levels.
ANNUAL HISTORICAL TREND
Medical trend stays consistent at 6.4%.
This marks the third straight year of medical trend above 6%, providing continuing evidence that medical trend has stabilized at a higher level than historical ranges, due to sustained pressure from both healthcare prices and healthcare demand.
2025 medical trend continued to be driven similarly by price and utilization, consistent with 2024’s trend and a departure from the price-driven medical trend of 2022-2023.
MEDICAL TRENDS
Pharmacy trend continues to remain elevated at 11.1%
Increases in price are driving prescription drug trend in 2025, with brand medications continuing to experience double-digit price increases as they did in 2023 and 2024.
While price remains the primary driver of pharmacy trend in 2025, overall pharmacy trend has decreased relative to 2024 due to a decrease in utilization.
Generic and specialty pharmacy are driving the reduction in utilization trend from 2024 to 2025.
The introduction of biosimilars, especially for Humira and Stelara, are contributing significantly to the reduction in specialty medication trend.
PHARMACY TRENDS
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