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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.

In 2013, the average cost of a year’s worth of specialty drugs was $53,000. If prices had risen at the rate of inflation, that number would land around $71,000 in 2025. Instead? It’s $84,000. That’s 18% higher than the projection at scale, and it’s also just the average, meaning many price tags are even higher.

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

by Aphora Expert
Published:
January 7, 2026
Last Updated:
January 7, 2026

In 2013, the average cost of a year’s worth of specialty drugs was $53,000.

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If prices had risen at the rate of inflation, that number would land around $71,000 in 2025.

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Instead? It’s $84,000. That’s 18% higher than the projection at scale, and it’s also just the average, meaning many price tags are even higher.

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Specialty drugs, which include treatments for conditions like cancer, autoimmune disorders, and rare genetic diseases, represent a growing share of healthcare costs. They’re prescribed to only 1–2% of the U.S. population, but they now account for over half of all drug spending. And they’re not just expensive; they’re accelerating.

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As employers and plan sponsors know too well, acceleration comes with consequences. Premiums rise. Out-of-pocket costs rise. So do deductibles, cost-sharing obligations, and administrative complexity. Even large employers report that specialty medications are now among the top threats to plan affordability. One report found that 3% of employees could drive up to 80% of a company’s pharmacy spend.

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The source of this spike? It’s not just innovation. It’s the lack of meaningful cost control.

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Many employers still rely on pharmacy benefit managers (PBMs) and traditional formularies that don’t reflect market efficiency or real-world value.

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But here’s the thing: you don’t have to absorb these costs.

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Aphora Health has developed a model that can help you cut specialty drug costs by up to 70%. That’s not hypothetical; we do it every day. We replace inflated pricing pipelines with rigorous clinical validation and a commitment to member-level impact.

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This is more than a discount program. It’s a strategy for realignment and planning for the future. We bring specialty drug spending back in proportion to reality, without compromising care. When your pharmacy benefits solution operates like a concierge, not a black box, savings follow.

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We know the cost explosion isn’t slowing down. The question is: will your strategy change before your budget does?

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Do you want to save up to 70%? Aphora Health is ready when you are.

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Contact us if you would like a summary of your savings – we will outline exactly where and how working with Aphora Health saves you money on your pharmacy benefits.

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