Combating Escalating Pharmacy Cost through Strategic Benefit Design and Management
Pharmacy costs are no longer a background trend for pharmacy benefit managers (PBMs) and/or employers (“Plan Sponsors”)—they are an immediate call to action that centers around benefit design considerations. With health care costs projected to rise by 9% in 2026 and specialty drugs driving 40% to 60% of total drug spend, plan sponsors need to decide where they will intervene, what level of cost exposure they will accept, and which management strategies they will implement now.
