Digestive diseases are a significant yet often underrecognized health burden in the U.S., impacting the gastrointestinal tract, liver and pancreas. Common conditions include gastroesophageal reflux (GERD), celiac disease, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), gallbladder disease and gastrointestinal (GI) cancers. These disorders affect immune function, nutrient absorption and mental health through gut-brain pathways.
A 2023 analysis found that 30.5% of commercially insured adults and 53.1% of Medicare beneficiaries have at least one digestive disease. Although GI cancers are less common, their incidence is rising. As people age, the number of cases increases and disparities remain. Younger adults are more likely to have conditions like IBS, while older adults are more likely to develop GERD. Financially, the impact is substantial: annual costs can reach $40,842 per patient for IBD and $22,123 for IBS.
The rapid rise in GLP-1 medications for weight management and diabetes is influencing digestive health. These drugs can cause gastrointestinal side effects, like nausea, vomiting, constipation and delayed gastric emptying. This is especially true when patients lack proper counseling on prevention and management. In a small group of patients receiving GLP therapy, this has resulted in additional consultations, diagnostic testing and symptom management interventions. However, these cases haven't been the main contributors to the overall increase in GI-related costs. On the other hand, GLP-1 drugs are effective treatment for fatty liver disease (steatohepatitis), which affects 5% of the population. GLP-1s are substantially less expensive than other treatments for this condition.
Despite widespread prevalence, care gaps remain. Stigma around symptoms and long wait times for gastroenterologists (6–12 months) hinder timely diagnosis. About 30% of members fail to obtain a diagnosis, leading to unnecessary imaging and prescriptions that inflate costs and worsen patient experience.
Management combines lifestyle changes, pharmacotherapy and sometimes surgery. Dietary interventions — such as probiotics, prebiotics and fiber — are foundational. Medications range from Proton Pump Inhibitors (PPIs) for GERD to biologics and Janus Kinase (JAK) inhibitors for IBD, which are effective but costly. Surgical procedures like cholecystectomy and colon resections remain common and expensive. The drug pipeline is growing with promising treatments for short bowel syndrome, gastroparesis and IBD. These treatments include dual biologic therapies and novel agents like glepaglutide, though costs can exceed $500K annually.
According to our 2025 Best Practices in Healthcare Survey, employer interest in digestive health solutions is growing. While only 8% of employer groups have implemented digestive health solutions in 2022, that number is projected to reach 40% by 2027. Despite this growth, satisfaction remains mixed, reflected in a net promoter score of -5, which is far below mental health (+21) and musculoskeletal care (+15). Additionally, 11% of employers plan to switch digestive health vendors within three years, signaling dissatisfaction and an opportunity for innovation. Employers are using tools like our Digestive Dashboard and exploring integrated care models that combine gastroenterology, nutrition and behavioral health. Virtual care providers that focus on digestive conditions are also gaining traction. They offer convenient access to multidisciplinary teams and show strong return on investment through improved symptom management and reduced unnecessary procedures.
Digestive health is emerging as a critical area for cost containment and improved outcomes. Employers can act now by using integrated care models, encouraging dietary changes and considering biosimilar-first strategies to manage rising drug costs. Moreover, proactive strategies to address GI side effects from GLP-1 medications — through education, monitoring and early intervention — will be essential to reduce unnecessary utilization and enhance member wellbeing.
