- Cancer, mental health, diabetes, obesity, and pregnancy and newborn costs are the five conditions shaping 2026 benefits planning decisions.
- Total plan-paid costs reached $613.30 per member per month (PMPM) in 2025, a 7.1% increase over 2024, driven by key cost drivers across medical and Rx spend.
- Specialty and brand-name drugs accounted for nearly half of the $40.50 PMPM year-over-year increase, with Rx spend growing at nearly twice the rate of medical spend.
ANN ARBOR, Mich., Aug. 20, 2026 /PRNewswire/ -- Springbuk by Truven, a health intelligence platform serving more than 7,500 mid-sized employers, released its mid-year Employee Health Trends report, identifying five key drivers behind a 7.1% increase in employer healthcare costs in 2025. Total plan-paid spend reached $613.30 PMPM, up from $572.80 in 2024, a year-over-year increase of $40.50 PMPM.
Prescription drug costs outpaced medical spend, with Rx PMPM rising 10.9% to $157.60 and now representing roughly one-quarter of total healthcare spend. Medical PMPM increased 5.8% to $455.70. Nearly half of the total cost increase, $19.60 of the $40.50 PMPM rise, came from specialty and brand name drugs.
Employee Health Trends: Five Key Cost Drivers in 2025
"Employers are increasingly data savvy and looking for early indicators of where healthcare costs, utilization and population health are headed next," said Marcy Tatsch, executive vice president and general manager of Truven. "Understanding cost trends in the data can help employers make more confident decisions about next year's benefits plans."
Cancer led increases in medical and Rx specialty drug spending, adding $5.70 PMPM combined. Breast cancer costs increased 14% despite only a 1% rise in prevalence, driven by higher-cost treatments.
Mental health contributed $3.50 PMPM to overall cost growth as more members sought care. The overall mental health claimant rate rose 7%, and behavioral health, which includes conditions such as substance abuse and autism, saw a 15% PMPM increase from $8.27 to $9.48.
Diabetes added $3.40 PMPM, driven by a mix of greater GLP-1 drug adoption and higher costs per member. Total diabetes brand Rx PMPM increased 11%, with prescription volume rising 7% and paid per script increasing 4%.
Pregnancy and newborn costs added $2.90 PMPM, driven by higher-cost pregnancies and newborn cases rather than increased birth volume. Spend per pregnancy rose from $9,416 to $10,101, while pregnancy volume increased only modestly from 20.7 to 20.9 per 1,000.
Obesity contributed $2.70 PMPM, due to increased utilization, consistent with rising adoption of GLP1-drugs. The obesity claimant rate rose 23% and scripts per 1,000 members increased 45%, while paid per script remained essentially flat at approximately $1,073.
The full Employee Health Trends 2026 report provides deeper analysis backed by billions of data points from more than 7,500 mid-sized employers.
Methodology: Findings are based on healthcare and benefits data from the Springbuk health intelligence platform. The mid-year update uses full-year 'calendar year' incurred claims data with '3 months of' runout to assess finalized 2025 cost and utilization trends and identify emerging trends relevant to employer benefits planning. Findings are reviewed alongside industry research and market trends to provide additional context.
About Springbuk by Truven
Springbuk, a health intelligence platform serving more than 7,500 employers, is part of the Truven portfolio of healthcare data and analytics solutions, backed by deep healthcare expertise. Powered by trusted intelligence, we help organizations understand, enhance, and maximize healthcare data to drive better health and financial outcomes. Through best-in-class data quality and market-leading solutions like Health Insights, MarketScan, and Springbuk, Truven serves 7 of the top U.S. health plans, more than 40% of the Fortune 500, and the top global pharmaceutical companies. Truven is a business unit of Merative, a data, software, and analytics company focused on driving real progress in health and social care. Learn more at merative.com/truven.
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SOURCE Truven by Merative
