U.S. employers are predicting a median health care cost increase of 10% for 2026, according to a survey from the International Foundation of Employee Benefit Plans.

The survey, Health Care Cost, Pulse Survey: 2026 Cost Trend, asked corporate and single employers what they think are the main drivers behind the rise in medical plan costs.

The top-listed reason, catastrophic claims, was shared by 31% of survey participants, up from 20% of participants in 2024. Other listed reasons were specialty/costly prescription drugs (23%); chronic health conditions (15%); and medical provider costs (11%, down from 18% in 2024).

For respondents who said specialty/costly prescription drugs were the main cause, the most-mentioned medication was GLP-1 drugs, cited by 59% (down from 75% of respondents in 2024). Half of the respondents picked cancer drugs; 21% selected cell and gene therapy; and 26% said “other drugs.”

Managing Costs

Survey participants also shared which health care initiatives they believe would be most effective in managing costs for the upcoming year.

Cost-sharing plans—including deductibles, coinsurance and copays—were mentioned most at 27%. Plan design proposals, including dependent eligibility audits and high-deductible health plans, were mentioned by 17% of respondents.

Purchasing/provider initiatives, including telemedicine and price transparency tools, were mentioned by 17% of respondents, nearly doubling from 9% in 2024. Utilization control strategies, including prior authorization, case management and disease management, were mentioned by 12% of respondents.

The International Foundation of Employee Benefit Plans surveyed 150 corporate and single employers online and through email from July 30 through August 7.