WTW survey signals fastest US employer healthcare cost growth in over two decades

WTW's 2026 employer healthcare survey says US employer healthcare costs are set to rise at their fastest pace in more than two decades. Pharmacy costs are up 11.5%, and nearly half of employers say significant changes to employee health plans are needed within three years.^[1]

Employer ratings of pharmacy benefit managers, or PBMs—firms that manage drug coverage and negotiate drug prices for health plans—also fell sharply.^[1] Separate coverage reports that 16% of employers are considering cutting weight-loss drug coverage; those changes remain under consideration.^[2]

For companies offering health benefits, higher bills raise the cost of employing people. Unless pricing or productivity offsets that increase, margins come under pressure. Rising pharmacy spending and weaker employer satisfaction with PBMs could encourage companies to renegotiate contracts, seek alternative providers or change which drugs their plans cover.^[1]

If employers narrow weight-loss drug coverage, some patients would have to pay more themselves and could forgo or delay treatment. That creates a demand risk for drugmakers such as Eli Lilly and Novo Nordisk; its size depends on how many employers actually make cuts and whether patients can afford treatment through other channels.^[2]

Impact

What to watch next

• The October 30 release of third-quarter US employment cost data will show quarterly benefit-cost growth, testing whether healthcare pressure is also visible in broader employer benefit costs.