Personalized medicine in health plans: A 2025 must-know for brokers
- Personalized medicine: 80% of employers will adopt personalized healthcare by 2025, reducing costs and improving outcomes.
- Rising drug costs: Specialty drugs drive over 50% of costs; programs like Intercept Rx’s Rx Optimization address affordability.
- AI in benefits: AI adoption in health benefits is set to grow 35%, helping brokers manage costs and claims efficiently.
- Mental health: Employers see a $4 return for every $1 invested in mental health benefits.
- Transparency: 75% of employers demand transparent PBM contracts; Intercept Rx delivers clarity and savings.
- Prevention & chronic care: Preventive care saves $100 per employee, while chronic conditions drive 90% of healthcare costs.
2025 health trends for brokers: What to expect and how to stay ahead
The healthcare industry is set for big changes in 2025, with new trends redefining how benefits are delivered and managed.
For health brokers and agents, staying ahead of these changes is key to helping employers build competitive, cost-effective health plans that meet the needs of their employees.
From the rise of personalized medicine to the growing focus on mental health, the industry is shifting in ways that demand fresh strategies and innovative solutions.
Brokers are at the center of this transformation, acting as guides to help employers navigate these new trends.
Companies like Intercept Rx are stepping up with cutting-edge tools, such as the Rx Optimization Program, which helps address rising prescription costs and improves access to care. If you want to know more about how it works, check out this article for a detailed guide.
This article breaks down the top health trends for 2025, offering practical insights that brokers can use to keep their clients ahead in an ever-changing landscape.
Have you heard of personalized medicine?
Personalized medicine is no longer a futuristic concept—it’s rapidly becoming a cornerstone of modern healthcare. This trend is reshaping how employers approach health benefits, with solutions tailored to the unique needs of individual employees.
One standout area in personalized healthcare is pharmacogenomics (PGx), which uses genetic information to predict how a person will respond to specific medications. This approach minimizes the trial-and-error process, leading to better outcomes and cost savings.
By 2025, 80% of employers are expected to incorporate personalized medicine into their health plans¹. The use of pharmacogenomic testing is one of the driving forces behind this adoption. Studies show that these tests can reduce medication trial-and-error, saving up to $6,000 per patient annually². Moreover, research indicates that at least 90% of people have actionable pharmacogenetic variants, emphasizing the value of integrating PGx into health plans³.
Personalized medicine isn’t just about improving care—it’s about empowering brokers to deliver innovative health plans that meet the demands of the modern workforce.
With this trend gaining momentum, brokers who embrace personalized healthcare solutions will stand out as forward-thinking advisors in a competitive industry.
How brokers can address rising prescription drug costs in 2025
Prescription drug costs continue to rise, creating challenges for employers trying to maintain affordable and comprehensive health benefits.
This trend is especially pronounced with specialty drugs, which are often life-changing but come with high price tags. These drugs account for over 50% of total drug costs, even though they make up less than 2% of all prescriptions⁴.
Overall, prescription drug spending is projected to increase by 5-7% annually through 2025, putting additional pressure on employers to manage rising healthcare expenses⁵.
For brokers, addressing these costs is crucial to staying competitive and delivering value to their clients. Employers are looking for innovative solutions to combat rising expenses while ensuring employees have access to essential medications.
Intercept Rx offers a forward-thinking approach with its Rx Optimization Program, which tackles these cost challenges head-on. This bolt-on program not only lowers prescription drug costs but also ensures employee affordability by providing benefits like $0 copays and free home delivery.
By aligning with solutions like this, brokers can help employers balance cost management with quality care, ultimately improving outcomes for their employees.
The rising cost of prescription drugs, particularly specialty medications, isn’t slowing down. Brokers who can introduce cost-saving strategies and align with transparent, innovative pharmacy solutions will position themselves as indispensable partners for their clients.
The impact of AI and technology in health benefits: How brokers can leverage them in 2025
Artificial intelligence (AI) and advanced technology are revolutionizing the healthcare industry, and brokers are uniquely positioned to leverage these tools to optimize benefits and manage costs for employers. By taking advantage of AI-driven solutions, brokers can analyze claims, predict spending patterns, and implement cost-saving measures with unprecedented precision.
The adoption of AI in health benefits is projected to grow by 35% in the next two years, reflecting a shift toward more data-driven decision-making⁶. Globally, AI integration has already increased from 50% to 72%, demonstrating its expanding influence across industries, including healthcare⁷.
Furthermore, the AI market is expected to grow at a compound annual growth rate (CAGR) of 36.6% from 2025 to 2030, emphasizing the potential for transformative change in how benefits are managed⁸.
Healthcare leaders are embracing AI technologies to address critical gaps in patient care, with 85% actively investing in or planning to invest in AI solutions⁹. These tools are improving efficiency, reducing delays, and ensuring that healthcare resources are allocated effectively.
For brokers, the use of AI isn’t just a trend—it’s a game-changer. Intercept Rx stands out by incorporating advanced technology to calculate claims and spending amounts efficiently, providing brokers and employers with the insights they need to control costs while maintaining high-quality care. This tech-driven approach positions brokers as forward-thinking advisors who bring cutting-edge solutions to their clients.
As AI continues to reshape the industry, brokers who embrace these technologies will be better equipped to deliver tailored, cost-effective health benefits that meet the evolving needs of employers and employees alike.
Why mental health and wellness benefits matter for brokers in 2025
Mental health and wellness have become top priorities for both employers and employees, solidifying their place as a critical component of comprehensive health plans.
This shift is driven by growing awareness of the impact mental health has on workplace productivity and employee well-being. For brokers, this presents an opportunity to include mental health benefits as a core part of their recommendations.
According to recent surveys, 60% of employees consider mental health benefits a top priority when choosing an employer. This trend is further supported by the American Psychological Association (APA), which found that 81% of workers believe employer support for mental health will significantly influence their future employment decisions¹⁰.
Additionally, a One Medical and Workplace Intelligence study reported that 64% of workers struggle with mental or behavioral health issues, underscoring the pressing need for employer-provided mental health resources¹¹.
Employers are responding to this demand. A Willis Towers Watson (WTW) survey revealed that 67% of U.S. employers plan to prioritize mental health and emotional well-being programs over the next three years¹².
Beyond meeting employee expectations, investing in mental health also makes financial sense. The World Health Organization (WHO) highlights that for every $1 invested in mental health support, employers see a $4 return in improved health and productivity¹³.
For brokers, the growing focus on mental health is an opportunity to lead by recommending holistic wellness offerings that integrate mental and physical health benefits.
Highlighting these solutions can not only meet the rising demand for mental health resources but also position brokers as forward-thinking advisors who understand the evolving needs of modern workplaces.
Addressing mental health is no longer optional—it’s essential. By incorporating these benefits into health plans, brokers can help employers support their workforce while achieving better health outcomes and stronger employee engagement.
Transparency and advocacy in pharmacy benefits: Key trends for brokers in 2025
Transparency in pharmacy benefits is becoming a top priority for employers, driving a shift away from traditional PBM models to more transparent and advocacy-focused solutions. Employers are increasingly demanding clarity in how PBMs manage costs, handle rebates, and ensure affordability for employees.
According to a 2024 study on pharmacy benefit trends, 75% of employers prioritize transparency in their PBM contracts, underscoring a growing expectation for open and honest partnerships¹⁴. This demand reflects frustrations with opaque pricing models and undisclosed revenue streams that can lead to higher costs for employers and employees alike.
Intercept Rx is at the forefront of this transformation. By adopting a transparent Pharmacy Benefit Solutions model, Intercept Rx delivers clear pricing structures, prioritizes member advocacy, and effectively lowers out-of-pocket costs for employees. These efforts not only help employers manage their pharmacy benefit spending but also ensure employees can afford the medications they need.
For brokers, aligning with transparent PBM solutions like those offered by Intercept Rx provides a competitive edge. It demonstrates a commitment to helping employers navigate complex pharmacy benefit landscapes while delivering real value. By embracing transparency and advocacy, brokers can strengthen trust with their clients and contribute to long-term cost management.
In a market increasingly focused on transparency, brokers who champion open, member-focused solutions will stand out as trusted advisors and essential partners in the evolving world of pharmacy benefits.
Preventive care and chronic disease management: Cost-saving strategies for 2025
Preventive care and chronic disease management are becoming critical components of modern health plans. Employers are increasingly recognizing the value of proactive health measures to reduce long-term costs and improve employee well-being. This focus is essential, given that chronic diseases account for 90% of the $4.1 trillion annual U.S. healthcare costs¹⁵.
Preventive care, such as screenings and wellness programs, can have a measurable financial impact. Studies indicate that preventive care measures can save employers up to $100 per employee annually¹⁶. By catching health issues early or preventing them entirely, employers can reduce medical claims and maintain a healthier workforce.
Brokers have a unique opportunity to guide employers toward solutions that prioritize preventive care and chronic disease management.
Partnering with PBMs like Intercept Rx, which integrates these strategies into their Pharmacy Benefit Solutions, enables brokers to offer plans that address rising healthcare costs while supporting employee health. These programs not only save money but also foster a culture of wellness within organizations, making employers more attractive to current and prospective talent.
Final thoughts: How brokers can stay ahead with 2025 health trends
The healthcare landscape is rapidly evolving, and 2025 is poised to be a transformative year for brokers and employers alike. From personalized medicine and AI-driven solutions to mental health support, transparency in pharmacy benefits, and preventive care programs, these trends are reshaping the way health plans are designed and delivered.
Intercept Rx is leading the charge by providing innovative Pharmacy Benefit Solutions, including its Rx Optimization Program. These solutions are designed to address rising costs, enhance employee access to care, and deliver measurable value to employers.
Brokers who align with forward-thinking partners like Intercept Rx can position themselves as trusted advisors in a competitive market.
To explore how Intercept Rx can help optimize pharmacy benefits for your clients, click here and get a free savings analysis. Stay ahead of the trends and ensure your clients have the tools they need to thrive in 2025 and beyond.
Footnote Markers:
⁶ https://www.mckinsey.com/capabilities/quantumblack/our-insights/the-state-of-ai
⁷ https://www.mckinsey.com/capabilities/quantumblack/our-insights/the-state-of-ai
⁸ https://www.grandviewresearch.com/industry-analysis/artificial-intelligence-ai-market
¹⁰ https://www.apa.org/pubs/reports/work-well-being/2022-mental-health-support
¹⁴ https://www.nationalalliancehealth.org/wp-content/uploads/Pulse-of-the-Purchaser-Fall-2024.pdf
¹⁵ https://www.cdc.gov/chronic-disease/data-research/facts-stats/index.html
