Finding Opportunities for Cost Savings in an Evolving Pharmacy Landscape

Pharmacy benefits have rapidly become one of the costliest and least predictable aspects of managing a healthcare budget.  

Rising specialty and high-cost drug utilization, opaque pharmacy benefit manager (PBM) contract and rebate structures, and intensifying regulatory and market pressures have created a complex pharmacy landscape. For plan sponsors, navigating this aspect of employee benefits can be confusing and frustrating as costs rise due to factors that seem beyond their control. 

With prescription drug costs projected to rise 11% in 2027, many employers are looking for opportunities to control their pharmacy spending while continuing to provide access and affordability to their members. The market is undeniably challenging, but there are strategies employers can leverage to help contain costs, even in today’s complicated environment.  

Identifying Opportunity in a Challenging Market

Pharmacy is at a critical inflection point, and employers are feeling the strain.   

The specialty drug market is experiencing unprecedented growth. The U.S. Food and Drug Administration approved 46 novel therapies in 2025. Seventy-two percent of these therapies were classified as specialty drugs. Gene and cell therapies continue to gain momentum. While these treatments show a great deal of promise for patients with rare, life-threatening diseases, they come with steep price tags, often costing millions of dollars for a single dose.  

Amid these skyrocketing costs, employers have an opportunity to explore different avenues for potential savings. One option is strategic procurement, or a more deliberate approach to purchasing medications.   

International Sourcing

International pharmacy sourcing has gained traction among U.S. employers as a solution for controlling pharmacy costs. In 2022, prescription drug prices (brand and generic) were 2.78 times as high as prices in comparison countries, according to a federal study. This imbalance has led some employers to adopt international pharmacy programs.  

Through international sourcing, employers obtain medications from licensed vendors in other countries, where prices are typically lower. Many employers purchase these medications from countries that have been designated as “Tier One” by the federal government, which means that a country has a highly regulated pharmaceutical supply chain and is considered a favorable trading partner. Countries with the Tier One distinction include nations like Canada, New Zealand, and Australia.  

For some organizations, this strategy can have a substantial impact. If a member of your organization is prescribed a high-cost specialty medication, for example, sourcing the drug internationally could generate thousands of dollars in monthly savings. Incorporated as part of a larger pharmacy benefits strategy, international sourcing can be an effective route for reducing overall prescription costs.  

Patient & Copay Assistance Programs

Patient assistance programs offer another opportunity for savings. These programs, typically run by pharmaceutical companies or third-party vendors, connect eligible employees with free or low-cost prescriptions. This strategy can help patients obtain the medication they need without creating a tremendous cost burden.   

Similarly, copay assistance programs can deliver meaningful financial savings. Many drug manufacturers offer these programs, which are designed to help offset out-of-pocket costs for individuals struggling to pay for their prescriptions. If an employee cannot afford their medication, they are more likely to skip treatment, which can cause their condition to worsen and lead to greater healthcare expenses later on. Connecting an employee with a copay assistance program can help them obtain the medications they need while reducing claims costs in the long run.  

Looking Ahead

Navigating today’s pharmacy landscape is no easy task. Employers may feel trapped in a system where costs continue to rise without a clear direction forward.  

That’s why it is important to engage with a broker who understands the complexities of the pharmacy landscape. Our team is here to help you develop a pharmacy benefits strategy that puts your needs at the forefront.   

Most employers anticipate their existing benefits strategy will face some pressure over the next two years. Taking a proactive approach to your pharmacy benefits can help you get ahead of challenges instead of letting them fester.  

With the right strategy in place, pharmacy benefits can be an opportunity rather than an obstacle.

Contact our health & benefits team by filling out the form below to discuss your pharmacy benefits strategy and cost management goals.