(Reuters) -CVS Health Corp ( CVS ) slashed its annual profit forecast and missed Wall Street estimates for first-quarter earnings on Wednesday, as elevated demand for non-urgent procedures increased medical costs at its health insurance business.

The U.S. healthcare giant cut its per-share adjusted earnings forecast for 2024 to at least $7.00 from at least $8.30, adding it anticipates the surge in medical procedures at its unit that houses health insurer Aetna to persist.

Shares of the company fell 9.7% to $61.15 in premarket trading. They have fallen about 14% so far this year, through Tuesday's close.

U.S. health insurers have had to contend with rising medical costs over the past few quarters following higher demand for procedures, especially among older adults, that were delayed during the pandemic.

CVS said in February it was seeing a rise in hip and knee surgeries, medical services related to the eyes, dental work, as well as vaccinations including the RSV shot during the last three months of 2023.

The company's health care benefits segment, which houses the Aetna unit, recorded medical cost ratio - the percentage of premiums spent on healthcare - of 90.4% for the first quarter. That compared with 84.6% a year earlier, and above analysts' average estimate of 88.43%, according to LSEG data.

Aetna is also expected to face pressure after the government announced 2025 reimbursement rates to providers of Medicare Advantage health plans below expectations, raising worries about a squeeze on margins.

Humana last week pulled its already trimmed 2025 profit forecast, citing the disappointing rates.

CVS, which withdrew its 2025 adjusted earnings forecast of $10 per share in August, said in February it was targeting low double-digit percentage growth.

On an adjusted basis, the company reported a profit of $1.31 per share for the three months ended March 31, below analysts' average estimate of $1.69.

(Reporting by Christy Santhosh and Leroy Leo in Bengaluru; Editing by Sriraj Kalluvila)