Benefits Think Preparing benefits for the next wave: Gene therapy medications

Published 7 Min Read

Gene therapy
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Healthcare costs continue to rise, leaving employers scrambling to manage benefits expenses. The Business Group on Health 2025 Employer Health Care Strategy Survey found that 76% of employers are “very concerned” about overall pharmacy costs. While GLP-1 drugs have dominated recent conversations, a new pharmaceutical cost challenge is emerging for benefits leaders: gene therapies.

These cutting-edge medications carry price tags reaching hundreds of thousands to millions of dollars per treatment. Although their per-member-per-year (PMPY) impact has remained relatively low due to the rare nature of the conditions they treat, that’s changing quickly. After reviewing trends in a health data set covering 300 million people in the U.S., we see that utilization rates for gene therapies have grown 42%, and PMPY spend doubled from 2022 to 2024. And we’re expecting this expansion to accelerate even further.

Katherine Shanahan
Senior pharmacy analytic advisor, Truven

Katherine Shanahan is Senior Pharmacy Analytic Advisor at Truven by Merative, where she helps commercial and government payers, providers, and researchers to develop and deliver actionable … Read full bio


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