普华永道（PwC）：2025年医疗成本趋势报告（英文版）（29页）.pdf

1、Medical cost trend:Behind the numbers 2025Heart of the matterCommercial health care spending is estimated to grow 8.0%and 7.5%between 2024 and 2025,its highest level in 13 years,for Group and Individual markets,respectively.This near-record high is driven by continued inflationary pressures,prescrip

2、tion drug spending,and behavioral health utilization without new meaningful deflators.The same inflationary pressure the healthcare industry has felt since 2022 is expected to persist into 2025,as providers look to pass their rising operational expenses to health plans.The utilization of Glucagon-li

3、ke Peptide-1(GLP-1)drugs is on a rising trajectory and can materially impact overall medical costs.Innovation in prescription drugs for chronic conditions and increasing use of behavioral health services are likely driving further cost inflation.Meanwhile,new deflators are not enough to offset these

4、 forces.Growing adoption of biosimilars may provide some relief,while many health plans are looking inward to find opportunities across business operations to generate additional savings.Other trends that health plans are keeping an eye on include CMS price transparency,implementation of generative

5、AI,the No Surprises Act and the Inflation Reduction Act.The 2023 and 2024 medical cost trends are also restated to be higher than previously reported based on the input of health plans we surveyed and their trend experience.This unfavorable development reflects higher than expected utilization of GL

6、P-1 drugs for both diabetes and weight management as well as higher acuity inpatient and outpatient utilization.Inpatient and outpatient utilization were driven by demand from deferred care since the pandemic,which was met by newly created inpatient and outpatient capacity given the shift in sites o