CPI reports that health care inflation increases

Inflation of health care feeds higher coverage costs, preparing the way for what could be the highest increase in health spending for large employers in 15 years.

Medical care costs in August increased by 4.2% on an annualized basis, according to the consumer price index of the Labor Department, compared to an overall inflation rate of 2.9%. The cost of visits to doctors increased by 3.5%, while hospital and ambulatory services jumped 5.3%.

These price increases contribute to higher health insurance costs for 2026. Consumers who are not eligible for government subsidies to buy health coverage on the law on affordable care could face two -digit bonuses increases for next year, according to the first deposits of insurers.

Workers with employers’ health coverage may also have to pay higher bonus and pocket fees next year.

Large employers have been planning their overall health coverage costs will increase on an average of 9% in 2026, according to several business group surveys, which would be the highest level of health care inflation since 2010.

More than half of the companies interviewed by the Consulting Society in benefits Mercer earlier this year have declared that they plan to transmit some of these workers’ increases, but the health group on health says that most of the large employers in its survey seek other ways to reduce costs.

“Employers have been unleashed in all possible ways, from the costs of costs to employees. This year, we see the first indication that they can seek to transmit part of this to employees, but again, only as a last resort. They will try to draw as much levers as possible,” said Ellen Kelsay, president and CEO of BGH.

Prescription drug prices increased by 0.9% in August, according to the consumer price index, which considers a range of generic and widely used brand drugs.

But for large employers, expensive drugs are the main drivers of higher health expenses.

The companies interviewed by BGH provide for a 12% increase in pharmaceutical costs next year, in addition to an increase of 11% this year fueled by cancer drugs and diabetes and obesity treatments like Novo Nordisk’s Wegovy and Ely Lilly Zepbound.

“Cancers have been for the fourth consecutive year, the main state leading to health care costs – cancers at a younger age, subsequent stadium diagnostics,” said Kelsay, who added that dear drugs are close to weight.

“Regarding the treatment of obesity, it is space that has been the most sparkling for two to three years and which has fueled a large part of these pharmaceutical expenses,” she said.

According to Mercer, almost two thirds of employers with 20,000 or more workers offer access to weight loss drugs known as GLP-1. Less than half of the small employers questioned have planned to provide access in 2026.

With growing demand for drugs, more and more companies are tightening the conditions of eligibility and begin to explore more affordable means of providing access to their employees, including the cash market.

A director of Télésanté whose company offers GLP-1 compounds told CNBC that some major employers allow workers to know that they can use savings accounts for purchase to buy drugs for less on the cash market.

“They are worried how much [the drugs] Cost, but that does not mean that they do not think that their employees should not have access to it. They just don’t want to have to pay for this, “said the executive, who spoke on condition of anonymity due to the confidential nature of the discussions.

Health account data shows that more workers are turning to direct options for consumers, including online pharmacies from Eli Lilly Direct and Novo Nordisk online online, which both offer their weight loss drugs at half of the prices on the list of more than $ 1,000.

GLP-1 purchases are now the main category of cash payment expenditure in flexible expenditure accounts before tax and health savings, for expenses not covered by insurance, according to the CEO of the Paytor Paytient.

“We see a hat-trick from last year to this year of use in GLP-1-oriented suppliers. These are places like Lilly Direct, like Ro, like Hims & Hers, and it is an increasing segment,” said Brian Whorley, founder and CEO of Paynient.

But employers fear that the cash trend is leaving low -income workers in the equation because they cannot afford the costs of the pocket. This causes discussions on how their companies can obtain cash payment prices to help stimulate more equitable access to employees.

Self-assured employers have followed a contract directly with so-called centers of excellence for specialized medical care such as cancer treatment and joint replacements. But they cannot do the same for many drugs. Under agreements with societies for managing benefits in pharmacies, or PBMS, drug manufacturers and employers would violate their contracts using a direct cash payment process.

But employers are pressing more and more PBM for better options, explains Kelsay de BGH. They are starting to consider new types of services managers, which offer new payment models for drugs in the development pipeline.

“There are new entities – certain startups in this space – which build products and solutions where they go in the name of a group of employers grouped together to negotiate with manufacturers on certain cellular and genic therapies,” she said.

The Whorley of Payient calls for the challenge of making the GLP-1 more affordable a stress test moment for employers and PBMs.

“They are in a sort of perfect Venn diagram of clinically effective drugs that change people’s lives, who will increasingly force a choice,” for funding, said Whorley. “If we get things correctly, this can provide a plan for all drugs like GLP-1 which … will present challenges for health plans.”