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Layering Pharmacy Solutions Without Plan Disruption

Pharmacy is one of the most dynamic areas of spend for self insured employers. Yet many plans still treat change as something that only happens at renewal. That delay is costly. Self insured employers can realize pharmacy savings without waiting for renewal. Immediate access to specialty, brand, and generic solutions matters to the bottom line.

The Real Measure of Pharmacy Benefit Success: What Employers Keep, Not Just What They Get Back

In pharmacy benefits, success is often summarized by a single number: the annual rebate check. It is tangible, easy to report, and frequently treated as a signal that a strategy is performing well.But rebates are only one part of the picture.

Why $0 Copays Often Cost Less: Medication Adherence as Preventive Medicine

Higher copays are consistently associated with lower medication adherence, which can shift costs from the pharmacy benefit to higher-cost medical services over time. Reducing or eliminating copays removes a common barrier to adherence and is associated with more consistent medication use in many employer populations.

Why Discounts and Rebates Do Not Always Equal Real Savings in Specialty Pharmacy

Specialty drug pricing that relies on discounts, rebates, and projections often hides what employers actually pay at the claim level, making true costs difficult to see and manage. Rebates frequently reward higher list prices and delay financial clarity, while true unit pricing at the point of dispense gives employers better cash flow, forecasting accuracy, and control over stop-loss risk.

Prescription Drugs: The Most Controllable Employer Healthcare Expense

Prescription drugs are a large but unusually controllable cost. Pharmacy benefits now account for roughly 25–27% of employer health-plan spending, driven largely by a tiny fraction of high-cost specialty drugs. Unlike medical claims, pharmacy costs use predictable, contract-based pricing, making them transparent, auditable, and adjustable with targeted interventions. Employers have clear levers to reduce pharmacy spend without harming care.

Pharmacy Deserts, Access Disruptions, and a Threat to Medication Adherence: A Look Into 2026

Pharmacy closures are no longer a hypothetical risk: With pharmacy deserts expanding through 2025, employees face growing barriers to medication access, driving lower adherence, worse health outcomes, and measurable productivity loss for employers.

A Drug Shouldn't Out Earn Your Employees

In 2025, the average American working full-time earns about $66,622 a year. Now consider this: the average annual cost of specialty drugs is $84,000 a year.

Specialty Drug Prices Are Spiraling Far Beyond Inflation – Here’s How To Stop It

Many employers still rely on pharmacy benefit managers (PBMs) and traditional formularies that don’t reflect market efficiency or real-world value. But here’s the thing: you don’t have to absorb these costs.

Utah’s Rebate Pass‑Through Mandate: Why Waiting Until July 2026 Isn’t Worth It

Utah’s 2025 pharmacy benefit law, effective for health plans issued or renewed on or after July 1 2026, requires health insurers to ensure that PBMs pass 100% of manufacturer rebates directly to members at the point of sale or use them to lower premiums or enhance benefits.

2025 Premiums Spike: Why Employers Are Turning to Self-Funding (and What’s Still Missing)

Premiums are rising fast. In 2025, employer-sponsored single and family coverage hit $9,325 and $26,993, driving a major shift toward self-funding and level-funded arrangements across all employer sizes.

PBM Transparency: Opening the Black Box of Drug Pricing

In this rapidly evolving landscape, transparency is not just a regulatory buzzword – it is a competitive advantage.

By 2027, Specialty Medication Will Cost Insurers 56% of Their Whole Budget... But What If You Could Shrink That To 17%?

It’s projected that by 2027, 56% of total insurance spend will go to specialty medications. But what if that same slice could be shrunk down to just 17%?

63% and Climbing: Why Employers Are Surging Toward Being Self-Insured In 2025

Self‑funding is no longer restricted to Fortune 500 companies.