How GLP-1 Growth and Specialty Drugs Are Driving Cost Pressure

Healthcare costs are continuing their upward climb, and according to a new report from PwC, the pharmacy trend continues to outpace overall medical trend, driven by specialty medicines and expanding GLP-1 utilization. The firm's annual Behind the Numbers 2027 analysis projects a 9% increase in medical cost trend in 2027, marking the fifth consecutive year of elevated healthcare inflation.¹ While provider reimbursement pressures, behavioral health utilization, and AI-enabled revenue cycle management remain major drivers of overall medical spending growth, more than 85% of surveyed health plan actuaries reported that pharmacy costs are rising faster than overall medical costs.¹ To unpack these findings, Pharmaceutical Commerce spoke to Philip Sclafani, a partner at PwC and key advisor to the report.

At the center of that growth are GLP-1 therapies. Once viewed primarily as diabetes treatments, these medicines have expanded into obesity, cardiovascular disease, chronic kidney disease, obstructive sleep apnea, and metabolic dysfunction-associated steatohepatitis (MASH). PwC notes that GLP-1 utilization continues to accelerate, with prescription volume increasing year over year and broader indications creating a much larger eligible patient population.¹ The report also highlights the arrival of new oral formulations, which could further expand adoption by lowering barriers associated with injectable therapies. Industry data from IQVIA similarly shows that GLP-1 medicines have had significant impact on spending growth since 2020.²

Another factor is the growing pipeline of specialty therapies. Although these treatments currently represent a relatively small share of total pharmaceutical volume, Sclafani notes their multimillion-dollar price tags can create substantial financial exposure for employers and health plans when even a handful of patients require treatment. Industry observers increasingly view these therapies as a new frontier in healthcare financing, prompting payers to explore alternative reimbursement models and risk-sharing arrangements as more products enter the market.

In this first installment of his conversation with PC, Sclafani discusses why pharmacy costs are rising at a faster rate than medical spending, how payers are approaching GLP-1 coverage decisions, and why specialty medicines, oncology innovations, and cell and gene therapies remain critical areas to watch as the industry prepares for another year of elevated healthcare costs.

References

1. PricewaterhouseCoopers (PwC). Behind the Numbers: Medical Cost Trend. PwC Health Research Institute. Accessed June 18, 2026. https://www.pwc.com/us/en/industries/health-industries/library/behind-the-numbers.html
2. IQVIA Institute. U.S. Medicine Use Trends 2026. IQVIA Institute for Human Data Science. Published April 28, 2026. Accessed June 18, 2026. https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/us-medicine-use-trends-2026