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Cardiovascular Disease Ranked Second Most Expensive Health Condition

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1.5 minute read

A report by independent stop-loss provider Sun Life found that cardiovascular disease surpassed blood cancers for the first time in 12 years. It has now become the second-highest stop-loss claim reimbursement during 2020-2023.

Sun Life’s report analyzed 60,000 stop-loss claims from 6 million people. Seventy-two percent of claims were from the top 10 conditions, with 37% of reimbursements from the top three conditions. Here are the top 10 conditions for the four-year view:

  1. Malignant neoplasms (solid tumors)
  2. Cardiovascular
  3. Leukemia, lymphoma, and multiple myeloma (blood cancers)
  4. Newborn and infant care
  5. Orthopedics and musculoskeletal
  6. Respiratory
  7. Sepsis
  8. Gastrointestinal and abdominal
  9. Neurological
  10. Urinary and renal

 

Here are some additional key findings:

  • The top 10 injectable medications accounted for more than $10 million in overall spending, with Keytruda maintaining its lead by surpassing $69.7 million in expenditure.
  • Five new medications have been added to the list of the top 20 high-cost injectable drugs for 2023, offering treatment for immunodeficiency disorders, cancer, gout, and blood disorders.
  • Million-dollar claims have increased by 8% in the past year and by 50% over the past four years.

 

Employer Takeaways

Sun Life's annual report helps self-funded employers understand high-cost medical and injectable drug claims trends and impacts. Employers may want to consider purchasing stop-loss coverage for self-funded health plans to enjoy flexibility without unlimited liability risk. Factors like cash flow, risk tolerance, and company size influence the level of protection needed for effective risk management decisions. Download the bulletin for more details.

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National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Scott Fritz

Scott Fritz

Scott Fritz always has a willingness to help others, which has made him an ideal candidate for working in the public sector benefits arena throughout his career. He’s a team player and enjoys strategizing, problem solving, and finding effective cost-saving solutions for his clients. As an Employee Benefit Consultant with National Insurance Services, Scott is responsible for the overall assessment and management of an employer’s benefit plans. He is a licensed insurance agent and works with schools, cities, counties, and community mental health organizations in Michigan and North Carolina.