Employers are about to hand their workers a bill nobody enjoys explaining. Marsh projects that total health benefit cost per employee will rise 8.2% on average in 2027, the steepest increase since 2003. That figure already counts the cost-saving steps employers plan to take, such as higher deductibles. Without those steps, employers expect an 11% jump. Open enrollment typically runs between September and November, and this year’s season is opening.
Employers are also trimming what they cover. Reports this month describe companies raising deductibles and dropping coverage for GLP-1 weight loss drugs to hold costs down. Forbes advises workers to price a high-deductible plan against the care they expect to use, instead of the monthly premium savings.
Every one of those decisions lands at the pharmacy counter. A higher deductible puts the first fills of the year at full price. A dropped drug turns a covered prescription into a cash-pay conversation. And the employee who hears the number in January will remember who explained the plan in October.
That employee often points at you.
What the data says happens next
RazorMetrics has polled insured consumers on drug costs for four years, and the 2026 State of Drug Access Survey shows a pattern that holds steady year after year. 43% of consumers were prescribed a medication they found too expensive in the past year. Over 75% of those reporting cost distress put their breaking point below $250. Sticker shock belongs to everyday prescriptions, and specialty drugs represent a small slice of it.
Price clarity comes next. 46% of consumers find it confusing to figure out the final price of a prescription. More than half lack confidence in the price they pay at the counter. Among the 55% who turn to an app or website to hunt for savings, 53% call the search difficult.
When the price stings, consumers reach for the phone. 46% call their doctor. 20% ask the pharmacist about a discount. 11% call their insurance company. 16% leave the prescription unfilled or ration it.
Your name appears nowhere on that list of first calls. The complaint still finds its way to your inbox by February.
What physicians see
We paired that consumer view with a second survey of 104 U.S. physicians, and the two datasets fit together like puzzle pieces. 96% of physicians report that a patient has stopped a medication over cost without telling them. Most spend more than 15 hours a week on prior authorization paperwork that produces few approvals.
The physician sits at the center of the moment when cost decisions get made, and patients trust them there. Roughly 90% of consumers say they will accept and fill a prescription their physician switches. 83.9% want their provider to automatically move them to the lowest-cost option. Convenience wins for 60.9% of consumers, so savings that ask employees to change pharmacies, download apps, or opt in to programs leave money on the table.
Three moves for your enrollment conversations
- Name the tradeoff out loud. Every plan design trades premium against deductible against formulary. Give clients a one-sentence version of each trade before enrollment opens. A client who chose the tradeoff owns the decision, and a client who heard a promise owns a grievance.
- Start at the pharmacy counter. Ask which medications employees fill most and where those prices land. The $100 to $250 range is where surprise begins, so the conversation belongs with the daily prescriptions. Walk clients through what a deductible increase does to the first fill of a common maintenance drug.
- Route cost decisions through physicians. Trust has migrated toward the prescriber, and the survey data shows employees want cost handled early, automatically, and inside clinical care. Recommend solutions that reach the physician at the moment of prescribing. RazorMetrics plugs into the prescriber’s existing workflow, earns a 76% physician response rate, and puts savings on the table before the prescription reaches the counter. Employees skip the apps and the opt-ins, and you skip the January apology tour.
The advisor people remember
Certainty sells in October. Clarity holds up in January. In a year when employer costs climb at the fastest pace in two decades, the broker who tells clients what to expect earns the renewal.
Join us Tuesday, September 29 at 12:00 p.m. ET for our webinar, where we walk through both surveys, the consumer view and the physician view, and show how the two connect. Bring your toughest enrollment question. Register here: https://razormetrics.com/webinars/two-surveys-one-gap/
