How are employers preparing for the potential cost of the 9 impact of high-cost gene and cellular therapies? 1,000 to 5,000 500 to 999 4,999 to 9,999 10,000+ employees employees employees employees Conduct risk assessment to estimate 15% 19% 21% 28% cost exposure Add/enhance stop-loss protection 4% 4% 8% 2% Work with medical carrier/pharmacy vendor 21% 40% 57% 52% on clinical/cost management strategies Other steps 1% 2% 3% 3% No plans, but aware of these therapies and 31% 34% 26% 25% concerned about potential cost impact Aware of these therapies but will treat 14% 13% 7% 6% them like other specialty drugs Not aware of these therapies 17% 7% 3% 6% Employers consider a role for the government in 昀椀nancing 9 high-cost drug therapies. The government 76% negotiates price for all payers for drugs above a certain dollar threshold 70% (e.g., $1M) and paid for out of a national fund. The government 50% implements a stop-loss program where costs above a certain dollar 47% threshold are covered by a national fund. 2019 2020 Shift patients with 35% certain high-cost conditions to Medicare. 40% 2023 Benefits Trends: The evolving workplace 69