The Brown & Brown High-Cost Claims Report, 2026 provides observations to employers on healthcare claimants exceeding $25,000 in medical and prescription drug allowed claims spend within a year (e.g., high-cost claimants). To develop this analysis, Brown & Brown utilized its medical and prescription drug claims data for the incurred periods of calendar year 2023 and calendar year 2024, with claims runout paid through June of each respective following year.
70% of Per Member Per Month (PMPM) claim trend was attributed to high-cost claimant impact
High-cost claimant prevalence increased 9.1%
Average spend per high-cost claimant remained stable
Primary medical conditions driving high-cost claimant activity include cancer, musculoskeletal, circulatory, and digestive
Primary medications driving high-cost claimant activity include Humira Pen, Stelara, Dupixent, and Skyrizi Pen
To learn more about each of these key findings and how they impact overall employer health plan costs, download the Executive Summary.