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.
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.
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.
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.
The source of this spike? It’s not just innovation. It’s the lack of meaningful cost control.
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.
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 transparent sourcing, rigorous clinical validation, and a commitment to member-level impact.
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.
We know the cost explosion isn’t slowing down. The question is: will your strategy change before your budget does?
Do you want to save up to 70%? Aphora Health is ready when you are.
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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