2025年医疗成本趋势报告-普华永道

PWCPWCCommercialhealthcarespendingisestimatedtogrow8.0%and7.5%between2024and2025,itscontinuedinflationarypressures,prescriptiondrugspending,andbehavioralhealthutilizationwithoutnewmeaningfuldeflators.Thesameinflationarypressurethehealthcareindustryhasfeltsince20asproviderslooktopasstheirrisingoperationalexpensestohealthplans.TheutilizationofGlucagon-likePeptide-1(GLP-1)drugsisonarisingtrajectoryandcanmateriallyInnovationinprescriptiondrugsforchronicconditionsandincreasinguseofbehavioralhealthservicesarelikelydrivingfurthercostinflation.Meanwhile,newdeflatorsarenotenoughtooffsettheseforces.Growingadoptionofbiosimilarsmayprovidesomerelief,whilemanyhealthplansarelookingopportunitiesacrossbusinessoperationstogenerateadditionalsavings.OthertrendsthathealthplansarekeepinganeyeonincludeCMSpricetransparency,implementationofgenerativeAI,andtheInflationReductionAct.The2023and2024medicalcosttrendsarealsorestatedtobehigherthanprevitheinputofhealthplanswesurveyedandtheirtrendexperience.ThisunfavorabledevelopmentreflectshigherthanexpectedutilizationofGLP-1drugsforbothdiabetesandweightmanagementaswellashigheracuityinpatientandoutpatientutilization.Inpatientandoutpatientutilizationweredrivenbydemandfromdeferredcaresincethepandemic,whichwasmetbynewlycreatedinpatientandoutpatientcapacitygiventheshiftinsitesofcaretowardsoutpatient,professional,ambulatorycaresettings.togenerateanestimateofmedicalcosttrendforthecomingyear.Theseplanscovermoremployer-sponsoredmembersand10millionAffordableCareAct(ACA)markemedicalcosttrendsignalsurgencytovarioushealthcareplayerstorethinktheirorganizationalstrategiestomoreeffectivelymanagethetotalcostofcare.Figure1.PwCHealthResearchInstitutemedicalcosttrends,2009-2025HRIprojectsmedicalcosttrendtobe8.0%forGroupand7.5%forIndividualin2025,upfrom7.5%and7.0%in202411.9%9.9%9.0%9.0%8.5%9.2%8.5%7.5%8.0%8.0%7.5%7.5%7.0%6.8%7.5%7.0%6.8%7.0%6.5%7.0%6.5%6.5%5.5%6.5%6.0%5.5%5.7%5.7%5.5%2007200820092010201120122013201420152016201720182019202020212022202320242025-.-Group查IndividualNote:2023and2024trendswererestatedtobehigherthanpreviouslyreported.ThisunfavorabledevelopmentreflectshigherthanexpectedutiliofGLP-1drugsforbothdiabetesandweightmanagementaswellashigheracuityinpatientandoutpatientutilization.Inflationanditsramificationsacrossthehealthcarethemainfactorsdrivingspendingin2025.•Inflationaryimpactonhealthcareproviders.Withhealthcareinflationoutpacingnationalinflationlevels,drivenprimarilybyrisingcostsofhospitalrelatedservices,hospitalsareexpectedtopassonimpacttohealthplansincontractnegotiations.Givenstringentregulationsongovernment-basedfeeschedules,privateCommericalcontractsareexpectedtomostheavilyfeeltheburden.•Newlaunchesandgrowthinprescriptiondrugsforchronicconditions,includingGLP-1,CNS,andmore.Biopharmaceuticalinnovationisyieldingnewtreatmentsforobesityandneurologicalconditions,suchasAlzheimer’sdiseaseandschizophrenia,aswellascellulargenetherapiesforrarediseases.Expectedhighutilizationontopofhighunitcostofthesedrugsputinflationarypressureonmedicalcosts.•Continuousriseofbehavioralhealth.Risingutilizationandunitcostofbehavioralhealthservices,exasperatedbylimitedsupplyandreimbursementchallenges,areexpectedtomaterializeashighercostsforhealthplansasproviderslookforhigherreimbursementrates.Newtrendsinthebiosimilarmarketcanbringsomerelief,overpoweringinflationaryforcesdemandhealthplanslookinwardforadditionalsavingsopportunities.•Biosimilarscomingtomarket.Thelaunchandadoptionofbiosimilarshavebeengeneratingsavings.Thenewprivate-labelbiosimilarmodelthisyearmaymarkaturningpointinthemarketwherethepotentialofbiosimilarsavingscanbemorefullyrealized.•Reassessingtotalcostofcaremanagement:Aholisticapproachtoaffordability.Traditionally,healthplansaddresschallengestoaffordabilitywithasiloedandmodularapproach.Recently,amorematureapproachisemerging:itisholisticandenterprise-wide,establishesadedicatedfunction,andanalyzesmultipleinterconnectedcomponentsthatdeterminepremiumcosts.Inadditiontotheinflatorsanddeflatorssummarizedinthisreport,therewereseveralotherfactorsreportedbyhealconsiderationsfortrenddevelopment,butwerenotthoughttobeasignificanttrendbenderasaninflatorordeflator.•CMSpricetransparency.TheCentersforMedicareandMedicaidServices(CMS)pricetransparencydatapresentsavaluableassetforcontractnegotiation,butfirstprovidersandhealthplansneedtoovercomechallengesintransformingandanalyzingdata.•ImplementationofgenerativeAI.NoneofthehealthplanswesurveyedexplicitlyfactoredintheimpactofGenAIinestimatingthe2024-25medicalcosttrend;however,GenAIandartificialintelligencebroadlyareexpectedtoplayasignificantroleinmakinghealthcaremoreaffordableaspayersandprovidersleverageGenAIacrossdifferentareasofthevaluechain.•Medicaidredetermination.ThenetimpactofMedicaidredeterminationcouldbeaninflatorordeflatorasredeterminationends,andmostplanswesurveyedindicatedtheimpacttobeneutralorlowonthe2025medicalcosttrend.•NoSurprisesAct.TheNoSuprisesActof2022mayhaveanimpactonin-networkandout-of-networkrates,mostnotablyforcareprovidedbyemergencyrooms,radiology,anesthesiaandpathology.•ImplicationsofInflationReductionAct.TheexpectedhigherinitialdrugpricesstemmingfromtheInflationReductionActof2022canserveasaninflatorintheCommercialmarketwherenegotiatedmaximumpricesdon’texist.Note:RecentreportsofincreasesinoutpatientutilizationamongMedicarepcommentedonduringtheresearchperiodforthisreport.TheIndividualmarkethasseensignificantgrowth,from12peopleenrolledin202Individualmarket-focusedplans,majorhealthplansinthemarketalsoofferplansintheIndividualmarketplace,competitionhasintensifiedinrecentyears.Theimpactofmajorfactorsdrivingmedicalcostsresonatesacrossbothmarkets.ThisreportdoesnotfocusontrendsinMedicareandMedicaid.Medicalcosttrendisdefinedastheprojectedpercentageincreaseinthcapitacostsofmedicalservicesandprescriptionmedicationstheprojectiontocalculatehealthplanpremiumspermemberthisyearwouldcost$10,500•Changesinthepriceofmedicalproductsandservicesandprescriptionmedications,knownasunitcostinflation.•Changesinthenumberorintensityofservicesusedorchangesinpercapitautilization.4vMedicalCostTrend:BAshospitalscontinuetofacplanswillfeelthepass-throughimpactinongoingcoWhilerecentyearsfollowingthepandemicsawsignificantinflationacrossallindustries,healthcareexpenditureslaggedbehindinflainoverallhouseholdexpendituresfrom2021through3Q’23.In4Q’23,healthcareinflationpulledahimpactsofongoingcontractrenegotiations.Figure2illustratesthecontinuousincreaseintheyear-over-yearhealtindex,withthisriseinbothutilizationandunitcostsstartinginthethirdquarterof2021andpersistinguntilahighofnearly3.0%inthefirstquarterof2024.Withinhealthexpenditures,thehospitalandrelatedservicesindexhasseenasignifmostrecenttwoquarters,hittingamorethan7-yearhighof6.3%growthin4Q’23relativeto4Q’22.Ontheotherhand,thehouseholdexpenditureindexhasdecreasedtonearly2.5%afterhittingahighof6.5%inthesecondquarterof2022.Generally,healthexpenditureinflationcontinuestolagbehindhospitalwageinflation.Despitetheseongoinginflationarypressures,industrymarghospitalsystemshavebouncedbackwith1Q’24marginsat4.7%relativetothelowof-0.6%in2022followingthepandemic,drivenbyincreasedrevenueduetoacombinationofhigherutilizationandisrebounding,someofthelargestsystemsexperiencednegativemarginsasrecentlyasyear-end2023,asprovidersstrongoingoperationaldifficulties.Hospitalshaveidentifiedworkforceshortages,inflationarypressures(laborandsupplycosts),andshiftsinutilizationpatterns(e.g.,numberofvisitsandsitkeyoperationalpressuresdrivingmargintrends.Asproviderslooktocombatinflationarystrugglesandfurtherimprovemargins,theyareturningtocontractnegotiationswithMedicalCostTrend:Bhealthplans,primarilyprivateinsurancecontracts,tooffsetrisingcosts.Givenconstraintsunderrequiredbudgetneutrality,rateincreasesongovernment-sponsoredinsuranceremainwellbelowcosttrends.Thefinal2024Medicareproviderratesarincreaserelativetocontractyear2023(0.4%3).Medicaidrawhilecontractedatthestatelevel,areusuallytiedtoafractionofMedicarerates(approximately72%acrossallservices4)withratechangescloselyfollowingMedicare.Despitehistoricalstudiesindicatingnoevidenceofcostshiftingbetweengovernmentandprivateinsurance,mostrecentresultsfromtheRANDstudyinagrowingspreadofMedicareversusCommerciaCommercialrateswereat253%ofMedicareratesin2022,upfrom246%in20205,suggestingproviderscontinuetobalancetheircostsacrossalllinesofbusinessthroughprivatecontracts.Basedonthe2023payermix6forhospitalrevenueandtheassumedMedicarateincrease,hospitalsratestomatchthe6%to7%increaseobservedinyear-over-yearexpenses,withcertainmajorhospitalsystemsrequiringsignificantlyhigherrateincreasesonCommerciaSeventypercentofhealthplansidentifiedinflationaryimpactsonprovidersasoneoftwotopdriversofincreasestomedicalcosts.Accordingly,healthplanscanexpectcontinuedpressuresoncontractnegotiationsasproviderslooktoreboundonfinancialperformanceandmakeupforflatreimbursementonMedicareandMedicaidrates.Payers’abilitytomanagerateincreasesincomingcontractrenewalswillbeakeyindicatorofwhoisleftwiththeburdenofrisingmedicalcosttrend.Figure2.ExpenditureandWageIndicesyear-over-yeargrowth2017–Q1'2024Q1’17Q2’17Q3’17Q4’17Q1’18Q2’18Q3’18Q4’18Q1’19Q2’19Q3’19Q4’19Q1’20Q2’20Q3’20Q4’20Q1’21Q2’21Q3’21Q4’21Q1’22Q2’22Q3’22Q4’22Q1’23Q2’23Q3’23Q4’23Q1’247%Q1’17Q2’17Q3’17Q4’17Q1’18Q2’18Q3’18Q4’18Q1’19Q2’19Q3’19Q4’19Q1’20Q2’20Q3’20Q4’20Q1’21Q2’21Q3’21Q4’21Q1’22Q2’22Q3’22Q4’22Q1’23Q2’23Q3’23Q4’23Q1’247%6%5%4%3%2%1%0%HealthExpenditureIndexHospitalWageIndexHospitalandRelatedServicesIndexHouseholdExpenditureIndexNationalWageIndexSource:BureauofEconomicAnalysisPersStatisticsConsumerPricFigure3.Hospitalsystemoperatingmargins20%15%10%5%0%-5%2022Providence2023Ascension2022Providence2023Ascension2024HCACommonSpiritTrinityHealth——IndustryAverageSource:Publiclyavailablehospitalfinancials,StrataNote:Hospitalsystem5Hospital,privateequityandotherHospital,privateequityandotherWhileitwasanotherstrongyearinhealthservicesdealswithvolumeswellabovepre-pandemiclevels,2023neverthelesssawa13%declineinvolumefrom202tobeimpactedbyheadwinds,suchashigher-for-longerinterestratesandincreasedfederalandstateregulatoryconcerns,drivinindustryhasobservedfewerprivateequitybackeddealswithashiftinspecialtiesthatexperiencehighgrowthrate(e.g.Despitetheevolvingdealslandscape,whensurveyeprivateequityandotherphysicianconsolidationasamongthetopthreeinflatorsthisyear(50%)ascomparedtotheprioryear(20%),likelyamanifestationofthelastingimpactofconsolidationoncontractnegotiationasexistingcontractscomeupforrenewalovertime.A2022reviewofstudies8indicatesthatactualimpactvarieswidelybytypesofconsolidationaswellascontextoftheconsolidationwithinthesametype.Sofar,thestrongestevidenceexistsforcorrelationbetweenhorizontalandcross-markethospitalconsolidationandhigherprices.Whiledataontheimpactstohealthcarecostsofthisheighteneddealsactivityisstillemerging,preliminarystudiesarequantifyingpriceincreasesintherangeof12%to21%9.Tobeconsolidationonmedicalcosttrends,healthplansshouldconsiderfuturedealtrendsatamoredetailedlevel,bysegmentaswellaslocalmarkets,specifictotheplan.MedicalCostTrend:BFigure4.Healthservicesdealvalue($billions)andvolume,2019-LTM4/30/24$199$199$102$92$54$72$115$102$92$54$72$115$58$60$29$11$23$58$60$29$11$2320192020202120222023AllotherdealsvalueSource:LevinProHC,LevinAssociates,LTM4/30/24referstotheperiodfromMay1,2023throughApril30,202sumduetorounding.Figure5.PE-backedhealthcareservicesplatformsbysegmentasofDecember31,2023,USandCanadaSpecialtypharmacyInfusionOthermedicalspecialistsDiagnosticlaboratoriesMusculoskeletalOncologyHome-basedcareSpecialtypharmacyInfusionOthermedicalspecialistsDiagnosticlaboratoriesMusculoskeletalOncologyHome-basedcareVisionABA&pediatrictherapyPrimarycareClinicalstaffingDermatologyCardiovascularGastroenterologyImagingDentalUrgent&MentalhealthcentersVeterinaryReproductivemedicineClinicaltrialsitesIDDcareOccupational&correctionalhealthcareEmergencymedicaltransporta-tionObstetrics&gynecologyAmbulatorysurgicalUrology&nephrology&throatSkillednursingemergencycareMultispecialtyclinics&networksHospitals&healthsystems-25-50%-0-25%0-25%25-50%50-75%75-100%+-75-100%+-25-50%-0-25%0-25%25-50%50-75%75-100%+Source:PitchbookQ42023HealthNote:SizerepresentsthenumberofPE-backedplatformsMedicalCostTrend:BHealthHealthplanswilllikelyencoufromproviders,whichcanplayoutforseveralyears.Healthplansshouldcontinuetorethinktheirstrategiesthatdelivergreateraffordability.Value-basedcare,targetedcaremanagemin-housedataanalyticsandharnessingthepowerofAItechnologycanhelpplansaggressivelycounteracttheforcesofinflation.workforceshortagesthatcontinueto7Pharmaceuticalcompanieshavesuccessfullyinvestedininnovationortherapiesformanychronicconditions,which,whiledeliveringimprovedhealthformanyconsumers,createssustainedinflationarypressureonmedicalcosttrendsincomingyears.Specifically,biopharmaceuticalinnovationisyieldingnewtreatmentsforobesityandneurologicalconditions,suchasAlzheimer’sdiseaseandschizophrenia,aswellascellulargenetThedrugslistedinFigure6,whichhavejustcometomarketlaunchsoon,areexpectedtohavesignificantlygreaterimpactonconditionsrelativetodrugsalreadyonthemarket.Therefore,higutilizationratesareexpectedforthesedrugsontopofknownhighunitcostwhichislikelytodriveupmedicalcostsinthenearfuture.MedicalCostTrend:BFigure6.Drugstowatchin2024-5Drugclass/nameagonistsVariousdrugstreatingtype2diabetes,chronicweightmanagement,decreasedsecondarycardiovascular2023;additionofsecondGLP-1weightlossmedications,newapprovedindicationetc.canfurtherdriveutilizationupconditions,suchasdrugsmarkbreakthroughsratesofclinicaltrialfailure.approvedin2024followingintravenousinfusion)10Costlybutsignificantlyclottingfactorreplacementtherapy,whichcostsupwardof$600,000.11RareconditionwithestimatedCostlybutanalternativetolifetimetransfusionsandchelatintherapywhichareestimatedtocost$5.4patientsintheUS.15dailyoralintake)16dailyoralintake)16millionpatientsintheUS.17GLP-1agonistsareatypeofmedicationthatmimicstheeffectsofahormonecalledglucagon-likepeptide-1(GLP-1),whichhelpstoregulatebloodsugarlevelsandpromoteweightloss.Theyfirstbecameamajorcostinflatorlastyeargivenaspicombinedwithhighunitcost–recentlistpricesrangeupwardof$11,000annually18,19,thoughpharmacybenefitmanagement(PBM)formularyrebatesdoloweractualnetcosts.Ayearofexperiencesinceourlastreportsubstantiatedtheinflationaryimpact,andhealthplanscontinuetoregardGLP-1asakecomingyears,with90%rankingthisfactorasoneofthetoptwoinflatorsfor2024-5.GLP-1agonistswereinitiallyapprovedin2005fortreatingtype2diabetes,withsubsequentapprovalsforchronicweightmanagementandriskreductionformajorcardiovascularaccumulatingevidenceofsafetyandefficacy20,21,recentyearssawasignificantincreaseinutilizationaacrossmanylinesofbusiness,includingIndmarkets(Figure8).Despecificallyhasincreasedsubstantiallmanufacturerstogodirectlytopatientsthroughnewmodelsandbusinessrelationships.Theimpactonmedicalcosttrendcanvarybyhealthplans,dependingontheirchoiceoncoverageforweightmanagement(mostplanscoveredGLP-1agonistsfortype2diabetes).Surveysindicatethatapproximately30%to40%ofemployer-sponsoredinsuranceplanscurrentlyalsocoverGLP-1agonistsforweightmanagement22.Intheshorttomediumterm,utilizationofGLP-1agonistsisanticipatedtocontinuetogrowinbothIndividualandGroupmarkets,drivenbythefollowingforces:expansion(studiesarebeingconductedforawiderangeofindications,includingParkinson’sdisease,sleepapnea,addiction,etc.),theavailabilityofZepbound®asasecondGLP-1weightlossagent,andgrowingpatientinterestandacceptance23.TheultimatemarketpenetrationofGLP-1agonistsremainsunknownatthispoint;nevertheless,avastbasepopulationexistsintheUS.Amongthe67.532.3%wereobeseand5.5%werediagnosedwithdiabetes(notmutuallyexclusive),accordingtoa2022NationSurvey24.Each10%ofthe32.3%obeseCommercialpopulationtakingGLP-1agonistsmeansa$30increasetomedicalcostpermonth.25Thelong-termsavingsgeneratedbythesedrugsneedmoretimetomanifestandthenreported,thebenefitsofmanagingweight–oneofthekeyeffectsofGLP-1agonists–includeloweringtherisksoftype2diabetes,heartdiseaseandstroke,allofwhichcarrysignificantmedicalandeconomiccosts26.Figure7.TimelineofGLP-1AgonistApprovalsbyIndicationOzempicsemaglutideByettaexenatidesemaglutideVictozaliraglutideOzempicsemaglutideByettaexenatidesemaglutideVictozaliraglutideMounjarotirzepatidedulaglutide12/5/20171/25/20105/13/20229/20/201910/20/20174/28/20059/18/201412/5/20171/25/20105/13/20229/20/201910/20/20174/28/200520052010201420172019202120222023202420052010201420172019202120222023202411/8/20236/4/202112/23/201411/8/20236/4/2021WegovysemaglutideChronicWeightWegovysemaglutideChronicWeightManagementZepboundtirzepatideChronicWeightManagementliraglutide3/8/2024ChronicWeightManagement3/8/2024WegovysemaglutideCardiovascularWegovysemaglutideCardiovascularRisksMedicalCostTrend:BMosthealthplansoffercoverageofGLP-1MosthealthplansoffercoverageofGLP-1agonistsfortype2diabetes.Forweightmanagement,GLP-1agonistsarenotconsideredas“essentialhealthbenefits”underthePatientProtectionandAffordableCareAct(“ACA”)andthereforenotrequiredtobecoveredbyplansponsors.Healthplansshouldconsidertheirbroaderweightmanagementbenefitstrategies,expectedcostsbasedontheirmemberdemographics,potentialcostsavings(ifquantifiablethroughanalysis),andeffectsonmemberoremployeesatisfactionandwell-being.Planscanmanagetheassociatedcostsbyconfirmingproperutilization(e.g.,guardagainstoff-labeluse,setBMIthresholdandco-morbidconditionscriteria,requireparticipationinholisticweightmanagementprogramsetc.)andincreasetheimpactthroughaccompanyingpatientengagementstrategies(e.g.,medicationadherencelimitedfillsto30-daysupplies,andlifestylecounseling,etc.).Lastly,healthplansshouldcloselymonitorregulatorychangesthatmightrequirecoverageforGLP-1agonistsforobesemembersmeetingcertaincriteria.ForexhasbeenintroducedintheCalifornialegislature;ifitbecomeslaw,thebiforobesitytreatment27.PhamaceuticalmanufactGLP-1agonistshavelaunchedasignificantopportunityforthemanufacturersalreadyinmarketandM&AandCommercialinvestmentinthearenawilllikelycontinueasmanufacturerslooktoposdifferentiatetheirassetstogainshare,whilemanagingpricingandgross-to-netimpact.Manufacturersarealsolikelytocontinueinnovatingtheircommercialmodeltodifferentiate,workaroundmarketaccessbarriersandprovideabetteroverallpatientandprescriberexpemodelisonesuchexample.ThesemodelswilllikelyspreadtootherapplicableconditionsandPharmamanufacturers(e.g.Pfizer’srecentlyannouncedmodel).LevolvingtheirproductsandpipelinestogainadvantagesiQ4W,etc.),moreconvenientroutesofadministratieffectsprofileandhealtheconomicsdata.MedicalCostTrend:BFigure8.2021-2023H1GLP-1utilization,unitcost,andcostaspercentageoftotalcosttrend,asexemplifiedbythebookofbusinessofpharmacybenefitmanagement(“PBM”)groupservingmorethan1.6millionGroupplanmembers76543210$13.56$8.99 $13.56$8.99202120222023H1GLP-1Utilizationper1,000MembersGLP-1GrossCostperMember(ContributiontoTotalGrossRxCost)GrossGrossCost/MemberCentralNervousSystemmedicationscomingtomarThecontinueddevelopmentandapprovalofnewCentralNervousSystem(“CNS”)drugs,whichhadanestimatedglobalmarketsizeof$128.3billionin2022costsinupcomingyears.CNSdrugsareusedtotreatbraindisorders,includingAlzheimer’sdisease,Parkinson’sdisease,multiplesclerosis(MS),bipolardisorderCNSdrugshavehadfailureforAlzheimer’sclinicaltrialshitting99%inthepastfewdecades.30However,recentadvancementsareintroducingawaveofinnovativedrugsforconditionssuchasAlzheimer'sdiseaseandschizophrenia.WhiletheapprovalandintroductionofinnovativeCNSdrugsholdpromiseforimprovingpatientoutcomes,theyalsopresentchallengestomanaginghealthcarecosts,asthesedrugscomewithhighpricetagsandfillinthepreviouslyunmetdemandandhighunitcost.Alzheimer’sdiseasehasseenanotabledevelopmentwiththerecentapprovalofon(LeqembiTM),in202331,whichisthefirstdrugtoslowthedelayofcognitivedeclineassociatedwithAlzheimer’s32.ThismarksaturningpointinAlzheimer'streatmentafteralonghistoryoffailedclinicaltrials33.Withnearly7millionAmericansimpactedbyAlzheimer’s34andanannuallistpriMedicareexpectstospend$3.5billiononcoverageforthisdrugin202536.Inadditiontothedirectdrugcostsforlecanemab,thereareassociatedcostsforgenetictesting,requiredbrainscans,andothermonitoring,bringingthetotalannualmedicalcoststoabove$80,00037.AnotherAlzheimer’sdrug,donanemab(KisunlaTM),wasapprovedJune202438andhasbeenshowntoslowtheprogressionofthedisease39;itisalsoexpectedtohavforschizophrenia,worksbyactivatingmuscarinicreceptorsunlikeotherschizophrenia-treatingdrugs.ItisexpectedtobeapprovedinQ3202441withanestimatedpriceof$16,000to$20,00042.AsdevelopmentsinCNSdrugresearchsystemisexpected.AsmoreCNSdrugsareapproved,healthplanswitreatments,whichtypicallycomewithhighpricetagsandincreasinglycomplexmonitoringprograms.Manymemberswhowerepreviouslyunabletogetapprovedforotherdrugs,didnothavesuccesswithexistingmedications,orarenewly