More than half of HR and benefits leaders name cancer drug therapy as their greatest unmanaged risk over the next three years. Yet when it comes to where executive attention actually goes, cancer consistently loses out to GLP-1 medications and mental health — categories with lower per-member cost impact but far higher media visibility. Looking back, most would agree the industry was late to the GLP-1 wave. This data suggests we may be equally late to the cancer crisis.
There is a dangerous mismatch between financial risk and strategic focus. Cancer dominates the top 10 highest-cost claimant list — 95% of respondents say 3 or more of their most expensive claimants are cancer-driven. Yet 62% say GLP-1s receive more executive attention, and 55% say the same about mental health. Combined, 94% say GLP-1s get the same or more attention than cancer. This isn't a case of competing priorities — it's the costliest clinical category being structurally overshadowed at the leadership level.
"Cancer gets more care as the other two have predictable treatment and outcomes."
"It is front and center as it affects employee productivity and costs for the company."
Employers report high confidence in their oncology management capabilities — 74% say their teams are "very equipped." But nearly half treat oncology as part of general specialty pharmacy rather than a distinct clinical category. Limited market engagement reinforces this dynamic: 62% of employers have never received a pitch on oncology management, and only 16% have ever been approached by a cancer center. The experts currently being relied upon don't have expertise specifically on cancer.
Confidence without specialized infrastructure is a liability. Among those who say they are "very equipped," 36% simultaneously manage oncology as part of general specialty pharmacy — not as a clinical category requiring specialized expertise. Only 6% of all employers use external oncology experts to review high-cost drug decisions. The rest rely on medical consultants (36%), pharmacy consultants (35%), and carrier/PBMs (22%) — generalists managing a specialist problem. Over half of respondents say only about half or fewer of cancer cases actually go through formal clinical review. And with 62% never having been pitched on oncology management, employers don't know what they don't know.
"We don't do this on a case-by-case basis except when there are a number of employee complaints."
"We go with oncology experts' recommendations. In some cases costs are higher but we are more human-centric."
77% of employers report strong visibility into cancer spend, with costs fully segmented and reviewed regularly. But tracking a problem is not the same as solving it. Only 31% report success in reducing catastrophic claim volatility — the outcome that most directly impacts plan performance. That means roughly 70% of employers still experience volatile, unpredictable cancer claims despite close monitoring. The financial outcomes simply aren't moving.
This is the predictable result of the pattern traced through this report. When cancer loses the attention war, gets managed with misplaced confidence, and is reviewed by generalists, the financial outcomes don't move. While 64% cite improved confidence in care decisions and 64% cite better employee experience, these gains are not translating into measurable financial impact. The one metric that directly impacts plan cost predictability — reducing catastrophic claim volatility — is being achieved by fewer than one in three employers. Meanwhile, 42% say they cannot routinely challenge PBM decisions on high-cost oncology drugs, limiting the effectiveness of existing guardrails.
"The biggest challenge is balancing access to the most effective treatments with the high and rapidly rising cost of cancer drugs. Many therapies are very expensive and treatment plans can be complex."
"Success would mean faster approvals, evidence-based guidance to oncologists upfront."
The data is clear: employers need specialized oncology oversight, not more generalist management. AccessHope connects your plan and your employees' community oncologists with subspecialists from National Cancer Institute-designated cancer centers — bringing the latest evidence-based expertise to every cancer case, without employees leaving home or switching doctors.
Learn How AccessHope Can Help →This research was designed to capture how large, self-funded U.S. employers manage, monitor, and govern cancer drug therapy within their health plans. The study was conducted in March 2026 via the Gather research platform.
Respondents were recruited from a nationally representative online panel of U.S. business professionals. All participants were screened and verified to meet the following eligibility criteria prior to survey entry:
Fieldwork was conducted from March 19–23, 2026. The median survey completion time was approximately 12 minutes. No incentive beyond the panel provider's standard compensation was offered.
All 110 respondents hold senior HR or People Operations leadership titles. The sample skews toward mid-large employers (5,000–9,999 employees), reflecting the segment most actively managing specialty pharmacy risk. A majority of respondents reported active cancer drug therapy caseloads of 6 or more members over the prior 24 months, indicating direct operational exposure to oncology management decisions.
The survey instrument contained 20 questions spanning five domains: cancer spend visibility and tracking, clinical governance and drug review processes, executive attention and risk prioritization, PBM relationship management, and outcomes measurement. Question formats included single-select, multi-select, and open-ended response types. The instrument was reviewed for clarity and bias prior to fielding.
All responses were cleaned and de-duplicated prior to analysis. Percentages for single-select questions are calculated from the total respondent base (N=110) and sum to 100% with standard rounding. Multi-select questions — including clinical strategies in place, outcomes achieved, and pitches received — allow multiple responses per respondent and may therefore exceed 100%; these are clearly labeled throughout the report. Verbatim quotes are drawn from open-ended survey responses and are included with respondent permission. No personally identifiable information was collected.
This study relies on self-reported data from a convenience sample of HR and benefits leaders recruited through an online panel. Results reflect respondent perceptions and may not represent the full population of large self-funded employers. Sample size (N=110) supports directional findings and identification of meaningful patterns but may not support subgroup analysis at statistical significance. All data was collected at a single point in time and does not capture longitudinal trends.
AccessHope is transforming cancer care in the workplace by connecting employees and their community oncologists with subspecialists from National Cancer Institute (NCI)-designated cancer centers. Through a unique employer-sponsored benefit, AccessHope provides expert-driven cancer support, including treatment review, molecular tumor analysis, and clinical trial matching — all without employees needing to leave home or switch doctors. In 93% of cases reviewed, AccessHope experts recommend improvements. Learn more at myaccesshope.org.
Gather is an AI-native research engine for marketing teams. Gather takes your business problems, designs the study, runs the interviews, and delivers insights and content that move your metrics — in hours, not months. By combining quantitative panels with AI-led qualitative interviews, Gather closes the gap between what businesses think customers want and what customers actually need. Backed by Anthropic, True Ventures, Menlo Ventures, and Ridge Ventures, Gather is headquartered in San Francisco. Learn more at gatherhq.com.