15%: Drug cost surge plunging many further into affordability crisis

Anyone who's picked up a prescription lately can relate: Rising drug prices are driving up costs across Connecticut's healthcare ecosystem and helping to worsen the state's affordability crisis.

Pharmacy expenses rose 15% year-over-year for customers of both ConnectiCare and UnitedHealthcare, insurance executives told a gathering sponsored by the Connecticut Insurance Department last month.

"New therapies and prescription drugs continue to enter the market at significant cost," said Connecticare President Mark Meador, citing the growing use of pricey GLP-1 drugs by both diabetics and those seeking weight loss.

Surging prescription drug costs were cited by insurers, hospitals and state regulators at an Insurance Department forum on coverage rates on August 26, with none offering hope of relief. The event at the Capitol dug into why insurers are asking for double-digit bumps in their rates for plans in Access Health CT, the state's insurance marketplace.

UnitedHealthcare Pricing Director Michael Duberowski said medical and pharmacy claim costs at the insurer had increased 25% in the past two years, forcing the company to raise premiums.

"This emerging experience is significantly higher than the trend assumptions in our previously approved rates, and has created substantial financial pressure on our block of business across virtually every category of care," Duberowski said.

Reacting to the average proposed rate hike of 16.2% for 2027 for individual and small group plans, lawmakers launched stinging critiques of the insurance industry, referencing record profits and multi-million-dollar CEO salaries.

State Rep. Tammy Nuccio, R-Tolland, also pointed out that drug prices overall have trended downward in recent months, in part due to the Trump administration's pricing deals with drugmakers and efforts like the TrumpRx marketplace.

"I'm wondering if there is any ability for the Department of Insurance and our rate filers to look at the last 12 months rather than all of 2025, and incorporate those downward trends that we're seeing, and see if that gives us any more ability for wiggle room within the rate increases," Nuccio said.

Regardless of recent trends, drug costs have been eating up a bigger chunk of overall healthcare spending, state regulators said. Commercial insurers paid more per customer for retail pharmacy costs ($1,844) in 2024 than hospital inpatient costs ($1,822). Direct-to-consumer ads like those cheesy pitches before your favorite TV show are also causing more people to take more drugs, adding to overall costs.

Hospitals, doctors and other providers are also grappling with the cost of higher drug prices. Hospital spending nationwide on drugs increased 13.6% in 2025, approximately four times faster than growth in hospital prices, according to the American Hospital Association.

At Connecticut hospitals, operating expense per adjusted patient day remains elevated and continues to increase, driven in part by higher labor and drug costs, the Connecticut Hospital Association said.

All those pharmacy charges and other medical bills are adding to an affordability crisis in the state that threatens Connecticut's economy, CBIA President and CEO Chris DiPentima said Wednesday.

In its latest Consumer Outlook report, the business group found that nearly half (48%) of residents surveyed said that paying medical expenses was difficult, and 59% reported that their healthcare costs had increased during the past year. Out-of-pocket medical expenses were a struggle for 46%, with 35% saying it was difficult to pay insurance premiums.

"When families struggle with affordability, employers struggle to attract and retain talent, and communities feel the impact," DiPentima said.

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