Use of medical services due to chronic conditions was cited less by employers as a reason for rising costs, the report found. Of those who said specialty prescription drugs were driving up prices, most specifically cited glucagon-like peptide-1 drugs (75%), while 19% said cell and gene therapy were driving up costs.

Less significant factors for cost increases are the increase in staff numbers, capacity utilization due to an ageing workforce, premiums for stop-loss insurance, the delay in preventive medicine due to the pandemic and the number of insured dependents.

“Employers report that catastrophic claims and specialty drugs are among the leading drivers of healthcare cost increases,” said Julie Stich, CEBS, VP of content at the foundation. “In 2024, employers have implemented several cost-control strategies, with an increased focus on utilization control and cost-sharing initiatives.”

When asked which initiatives would have the greatest impact on cost control in 2025, the largest share of employers (27%) responded to utilization control initiatives such as prior authorization, case management, disease management and caregiver advisory centers, up from just 22% last year.

21 percent supported cost-sharing initiatives such as deductibles, copayments, co-payments and premium contributions (up from 16 percent last year). 15 percent are considering plan design initiatives such as dependent eligibility checks, high-deductible health plans, spousal supplements/waivers and drug list changes (up from 12 percent last year). 9 percent supported purchasing/provider initiatives including telemedicine, price transparency tools, centers of excellence, health navigators/advocates, coalitions and quality initiatives (up from 12 percent last year).

Employers are also interested, but to a lesser extent, in data analytics initiatives, including claims audits, utilization reviews, predictive modeling and AI tools, and workplace and wellness programs.