A new report from the Employee Benefit Research Institute shows that the use of cell and gene therapies within U.S. employer-sponsored health plans remains limited but is gradually increasing, as employers prepare for the financial implications of next-generation medical treatments.
The analysis found that in 2022, just 9.2 per 100,000 enrollees in employment-based plans received a cell or gene therapy, up from 7.9 per 100,000 in 2018. Although utilization is still rare, researchers say the upward trend reflects a growing pipeline of therapies that could reshape health plan costs in the coming years.
Cell and gene therapies target diseases at the cellular or genetic level and can potentially cure serious conditions such as sickle cell disease and hemophilia. However, these treatments are among the most expensive in modern medicine, raising concerns among employers and insurers about long-term affordability.
According to the report, the U.S. Food and Drug Administration had approved 48 cell and gene therapies as of 2025, with many additional treatments in development. Researchers noted that an increasing number of therapies are aimed at conditions affecting broader patient populations rather than only rare diseases, which could expand future demand.
Despite their high price tags, users of cell and gene therapies account for fewer than 0.1 percent of employer plan enrollees but represent roughly 0.5 percent of total health spending. Among the highest-cost claimants, only a small share received these treatments, yet their care accounted for a disproportionate portion of spending within that group.
Paul Fronstin, director of health benefits research at EBRI, said the findings highlight the importance of planning ahead.
“Cell and gene therapies remain uncommon in employment-based plans today, but the trajectory matters,” Fronstin said. “Employers, insurers, and policymakers should begin testing financing and payment models now to preserve access while managing risk as the pipeline expands.”
The report suggests that traditional cost-sharing tools, such as deductibles and out-of-pocket limits, may have little effect on utilization among patients who require these therapies. Employer size also plays a role in financial risk, with larger self-insured companies better able to spread costs across their workforce, while smaller employers may face significant exposure from even a single multimillion-dollar claim.
To address potential financial strain, employers and insurers are exploring strategies, including stop-loss insurance, reinsurance programs, value-based payment models, performance-based contracts, and amortized payment structures. Many of these approaches remain experimental, and researchers say further evaluation will be necessary as use of the therapies grows.
As medical innovation accelerates, the study underscores a central challenge for employer-sponsored health coverage: balancing access to groundbreaking treatments with the need to maintain sustainable health plan costs.
The findings suggest that while cell and gene therapies are not yet a major driver of employer health spending, they could become a significant factor as approvals increase and treatments become more widely applicable.
