Heart disease now 2nd costliest ailment for U.S. businesses, report finds
According to the report, reimbursements for cardiovascular diseases surpassed blood cancers for the first time in 12 years.
A new annual report released by Sun Life, an international financial services organization and the largest independent stop-loss provider in the U.S., analyzed 60,000 stop-loss claims from a member database of 6 million people.
The report revealed a number of significant findings, including that cardiovascular disease rose to second place on the list of highest stop-loss claim reimbursements over a four-year period from 2020 to 2023. According to the report, reimbursements for cardiovascular diseases surpassed blood cancers for the first time in 12 years.
Malignant neoplasm (solid tumors) topped the list of highest reimbursements in 2023 followed by cardiovascular disease, newborn/infant care, orthopedics/musculoskeletal care and leukemia/lymphoma and multiple myeloma. The report found that in 2023, U.S. companies received $415.6 million in reimbursements for malignant neoplasm alone.
Notably, claims for newborn/infant care disease/disorders rose by an average of $100,000 from 2022 to 2023, with an annual average cost of $470,800, according to the report. The highest reported claim for the condition was $11.5 million.
As in previous years, multimillion dollar claims continue to rise. The report found that all 20 claim categories experienced at least one, $1 million claim, with the highest cost claim for newborn/infant care coming in at over $11 million. Additionally, there were 32 claims in the $3 million category in 2023 – nearly double the number of such claims in 2022.
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When it comes to injectable drugs, the report found that the top 10 drugs had more than $10 million in total spend. Keytruda claimed the top position for the past four years and totaled nearly $70 million in 2023 alone. Of the top 20 injectable drugs, 11 were used primarily in the treatment of cancer. In 2023, the list for the top-20 high-cost injectable drugs saw five new additions – two of which are used primarily in the treatment of cancer.
The report found that throughout the years 2019 to 2022, 87% of employers were likely to experience a stop-loss claim in any given year. Thirty-two members had a claim over $3 million; nine of which were over $5 million, with the highest being over $11 million.