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Large employers expect healthcare costs to be 50% higher in 2025 than in 2017, and spending on prescription drugs – including Glucagon-like peptide-1 drugs or GLP-1 – is likely to be a key driver of these increases, representatives of the Business Group on Health said during a press conference on Tuesday.

The organization’s survey of 125 large employers found that 56% said GLP-1 drugs impacted their health care costs to either a “very large” or “large” extent. At the same time, 70% said they were “very concerned” about the appropriate use and long-term cost impact of GLP-1 drugs and other, newer weight-management drugs.

GLP-1 drugs represent a class of drugs that have recently received some regulatory approvals for use in weight management and to reduce the risk of heart attack, stroke or death in People with cardiovascular diseasesHowever, due to the high cost of these medications, employers are reluctant to ensure that their health insurance companies cover the costs.

The proportion of employers providing coverage varied depending on the conditions for which the drugs were prescribed. The BGH found that almost all respondents covered GLP-1 drugs to treat diabetes, while 67% covered prescriptions to treat obesity and only 34% did so to treat cardiovascular disease.

Ellen Kelsay, president and CEO of BGH, said Tuesday that employers have implemented requirements to control the use of GLP-1 drugs, including 87 percent that have obtained prior authorization. More than half of employers required plan members to participate in a weight management program, meet a certain body mass index threshold or have certain comorbidities.

Although it was not captured in the survey data, Kelsay also said she has heard anecdotally that employers are concerned about employees obtaining GLP-1 drugs from direct sales platforms and pharmacies that manufacture their own drugs and do not have physician oversight.

“They’re getting questionable quality in terms of the medications and questionable guidance in terms of support from the provider, who is often not a clinician overseeing that care,” she said. “There’s just a general concern that this is something that should be watched with great concern. Employers are certainly not encouraging their employees to go down that path, although they are aware that some employees are on their own.”

In this regard, 24% of respondents said they would require plan members to purchase GLP-1 drugs through specific doctors or programs, said Brenna Shebel, vice president at BGH.

GLP-1 drugs are a “significant factor” in the increase in costs, but also one of many, said Kelsay. She pointed out that cancer – the BGH discovered two years ago as a significant future problem for employer plans – topped the list of cost-driving conditions for the third year in a row.

Overall, 72% of respondents said they are already seeing higher rates of cancer among their patients, and another 16% said they expect it to impact. Kelsay said employers have also reported an increase in cancer diagnoses among younger patients.

This may explain why 87% of employers plan to cover at least one additional cancer screening test beyond what is recommended by health professionals. 49% of employers said they currently cover the cost of an alternative to colonoscopy.

The BGH’s findings on cost increases are generally consistent with those of other companies. Respondents forecast a 7.8% increase in costs for 2025 before changes in plan design. A survey published earlier this month by the International Foundation of Employee Benefit Plans also found predicted a cost increase of 8%.

“Health care costs are the real theme of this year’s results,” Kelsay said, adding that the trend of rising costs “has continued to be a troubling issue, especially this year.”