It’s possible to rein in pharmacy spend, but employers and their members are up against difficult challenges.
Premiums for family health coverage are over $19,000 per employee and rising rapidly.
75% of the ~7,000 medications in development are specialty.
Specialty has ballooned to almost 50% of medication spend, but it only represents 1-2% of the population.
Utilization is responsible for ¾ of specialty pharmacy trend, so lower rates and higher rebates won’t stop the spend.
Employers face misaligned incentives, a patchwork quilt of programs, and the nickel-and-diming of program buy-ups.
Equates to $35 PMPM in savings, mostly driven by impacting utilization
Compared to 5-8% for competitors
Compared to <10 for competitors
We call it MEDS. It's more than an acronym - it's a philosophy. With MEDS, we develop trusted relationships with our members through accurate and empathetic support, enabling us to guide them towards better medication selection and healthier choices.
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