6 specialty medicine trends for 2027 and what they mean for benefits leaders

By Hayden Goethe

Senior Content Marketing Manager

If it feels like specialty medicine is changing faster than your benefits strategy can keep up, that’s because it is. Healthcare cost trend is projected to climb to 9.2% in 2027. High-cost claimants and specialty drugs are two of the top factors driving the rise in healthcare costs, according to a recent survey. 

At the same time, the specialty drug market grew to $129 billion in 2024, and it is projected to reach roughly $1 trillion by 2030. Familiar infusions are becoming quick injections, and biosimilars are arriving in the medical benefit.

So what should you be preparing for in 2027? We asked Leap leaders one question:

What’s the one trend you see coming in specialty medicine in 2027?

Here are six trends that stood out, along with data and five steps to help you plan ahead:

1. Bigger rewards for choosing lower-cost care

The predictions:

“Employers will create significant financial rewards, not just incentives, for employees to choose lower-cost care. With potential individual patient savings exceeding $100,000 a year, employers will create larger carrots for employees to choose lower-cost providers.”

Rob LaHayne, Co-Founder and Chief Commercial Officer, Leap

“Employers want more from companies like ours. How can we get more members to do things differently than typical healthcare professionals and systems have trained them?” 

Sue Giordano, SVP, Client Success, Leap

Why it matters:

When a single member’s annual specialty drug cost can drop by tens or even hundreds of thousands of dollars, a few hundred dollars in waived cost-sharing becomes a small price for a large return that can also result in a better experience for the patient. 

Key stats:

• Removing the markup on a single member’s Keytruda treatment can save an employer $60,000-$255,000 a year, based on Leap’s analysis of 20 million commercial claims.
• Up to $3 million in potential savings per 10,000 covered members, according to a Leap analysis of internal data.

2. Specialty drugs leave the infusion chair

The prediction:

“Specialty drugs will keep moving out of the infusion chair, faster and faster. Many major IV drugs now come as a quick shot under the skin. In 2027, many patients who used to sit through multi-hour infusions will switch to faster shots at home.”

Martin Carrizosa, Head of Member Operations & Strategy, Leap

Why it matters:

For employers, a shorter appointment won’t necessarily lead to a lower-priced treatment. A five-minute injection given in a hospital outpatient department can still carry a considerable hospital markup. It’s also worth noting that every switch, whether IV to shot or brand to biosimilar, creates potential work and risk, such as: 

• A new prior authorization.
• A new pharmacy.
• New training.
• A chance for the member to fall through the cracks.

Key stats:

• Keytruda Qlex can be given by a healthcare provider in one minute every three weeks or two minutes every six weeks, compared with a 30-minute IV infusion for Keytruda
• Subcutaneous versions of Opdivo and Tecentriq can now be administered in five to seven minutes.
• In a pivotal trial, subcutaneous pembrolizumab cut patient chair time nearly in half compared with IV treatments.

3. Biosimilars: the lowest list price isn’t the lowest net cost

The prediction:

“There will be greater attention on which version of a biologic patients receive, as more biosimilars reach the market in the medical benefit space. Prolia and Xgeva now have several biosimilars, and more are on the way in oncology, all with no clinically meaningful differences from the brand.”

Sofia Shrestha, Senior Director of Clinical Strategy, Leap

Why it matters:

A biosimilar (a highly similar, typically lower-cost version of a biologic that the FDA has found to have no clinically meaningful difference from the approved drug) can give patients and employers real lower-cost options, but the savings aren’t automatic. The lowest list price isn’t always the lowest net cost, and many plans aren’t set up to review prices drug by drug and member by member. 

Every drug  switch needs a care team that watches for new options, works with the prescriber, and moves forward only when it’s clinically appropriate and safe for the patient.

Key stats:

• The FDA approved 18 denosumab biosimilars (versions of Prolia and Xgeva) by the end of 2025 alone.
• Federal analysis found that even with competition, biosimilar prices run at most about 25% below the original biologic, which is why net cost matters more than list price.

4. Employers move past site-of-care programs

The prediction:

“More employers will move past site-of-care programs in 2027. Those programs have had little impact on employer healthcare costs, because sending a patient from one provider marking up a drug 200 to 300% to another marking it up 50 or 60% still leaves a markup on the drug. Employers will look for partners that specialize in delivering better care at better prices, inside the benefit they already have.”

Rob LaHayne, Co-Founder and Chief Commercial Officer, Leap

Why it matters:

Site-of-care programs move members out of the hospital outpatient department (HOPD), the highest-cost setting, and into a cheaper one. The trouble is that the cheaper setting often runs on the same buy-and-bill model, where the provider buys the drug, marks it up, and bundles the markup into a single J-code claim the employer can’t see inside. Identifying solutions that eliminate the drug markup, which can run as much as 400%, will be a top priority as employers look to contain rising healthcare costs. 

Key stat:

• Single-encounter markups can vary in cost. For example, in a recent Leap impact analysis of one employer, a single Ocrevus 600mg encounter ran about $111,000 in a hospital outpatient setting and about $42,000 through Leap (including care coordination and clinical delivery). That’s a 62% savings. 

5. Innovation outpaces the systems built to pay for it

The prediction:

“Medical breakthroughs are moving faster than the systems built to pay for them, and 2027 is the year that gap forces change. New gene-editing and cell therapies for conditions like hereditary angioedema, Duchenne muscular dystrophy, and autoimmune disease are coming, many with price tags in the millions.”

Christine Hummel, SVP of Manufacturer and Specialty Network Partnerships, Leap

Why it matters:

The bottleneck for new specialty drugs could move from the FDA to the benefit plan in 2027. Some reviews that used to take a year now take a month or two. Faster approval doesn’t mean lower cost, and expensive new therapies will show up in claims before most coverage policies are written. Employers who wait for a therapy to appear in their claims before deciding how to cover it will make that decision under pressure, often for a member who needs treatment now.

Key stats:

• In 1995, there were fewer than 30 specialty drugs on the market. Today, there are nearly 1,000, and roughly 75% of the 7,000 drugs in development are specialty drugs.
• The FDA’s Commissioner’s National Priority Voucher program aims to cut review times for qualifying drugs and biologics from 10-12 months to one to two months.

6. 340B reform adds paperwork without slowing growth

The prediction:

“Attempts to curb 340B misuse will drive more administrative burden for all participants but do little to curtail growth in the 340B channel.”

Amir Sharif, Co-Founder and President, Leap

Why it matters:

340B is a federal program that requires drug manufacturers to sell outpatient drugs at steep discounts to qualifying hospitals and clinics. It has grown faster than the rest of the U.S. drug market. Changes could be coming as the system comes under scrutiny, and those changes could add reporting requirements across the system. For employers, the practical issue is visibility: The discount goes to the hospital or clinic, while a commercial plan is typically billed at its negotiated rate for the same drug.

Key stats:

• Discounted purchases under 340B reached $100 billion in 2025, which was 23% higher than in 2024.
• High-cost drugs bought through specialty channels made up 38% of units purchased under 340B in 2025 but drove 61.9% of total program spending.

How can you be ready for these expected trends? 

Here are five steps benefits leaders can take now to stay ahead:

• Look inside your specialty drug claims. Ask your carrier or TPA to see the drug cost separately from administration fees and provider margin, and whether any of those drugs were bought at 340B prices. If the answer is a single bundled J-code line, you’re paying for markup you can’t measure.
• Measure savings against paid claims, not list prices or projections. Whether you’re evaluating a site-of-care program, a biosimilar switch, or a new partner, the number that matters is what your plan actually paid. Building the business case on your own claims data also gives your CFO a savings figure they can audit after the fact.
• Make sure someone owns every switch. A move from IV to injection, or from a brand biologic to a biosimilar, can mean a new prior authorization, a new pharmacy, and new training for the member. Confirm who coordinates those changes with the prescriber and the member, so therapy doesn’t stall in the handoff. With Leap, every member is paired with a dedicated Care Guide who coordinates prior authorization, prescriber communication, pharmacy logistics, scheduling, and follow-up. 
• Size member rewards to the savings at stake. When one member’s annual specialty drug cost can drop by tens of thousands of dollars, reducing or waiving out-of-pocket costs for lower-cost options is a modest investment. Pair the reward with a conversation, ideally before the site-of-care decision is made, since members on long-term therapy rarely change providers for cost alone.
• Plan for new therapies before they reach your claims. Ask your partners how they track the drug pipeline against your members’ conditions, set a coverage process for breakthrough therapies in advance, and review your stop-loss coverage with million-dollar treatments in mind.

Find out what specialty medicine is costing you

A claims-based savings analysis built on your own data shows where markup is hiding, drug by drug and member by member. Request a claims-based savings analysis today.

About the author

Goethe is the Senior Content Marketing Manager at Leap. He brings a decade of experience as a content marketer in the healthcare industry and a deep understanding of the needs of benefits teams and their members to his work. Prior to that, he worked more than a decade as a journalist. He's certified in both content marketing and SEO.