Most employers have never seen a breakdown of their pharmacy claims.
Not because you are too busy. Because no one has shown you the data.
We met with a 3,400-employee group that had never seen their drug spend breakdown. When we pulled the numbers, 25 percent of their entire benefits budget was prescriptions.
That is not unusual anymore. Pharmacy used to be 12-14 percent of total spend. Today it is 20-25 percent for most groups. Some are north of 50 percent.
The Work Is Not Getting Done
Your broker negotiates a lower increase and moves on. Meanwhile, your pharmacy spend keeps climbing.
Most advisors do not have the tools or expertise to analyze pharmacy data at this level. It requires specialized analysis that goes beyond traditional renewal management.
We recently completed a pharmacy assessment for a 1,500-employee group. We found over $1,000,000 in potential savings from six medications alone. Same drugs. Same employees. No disruption.
For many self-funded employers, a single high-cost medication can swing their renewal into double digits. And because carriers rarely show the full picture, you end up paying more than you should with no real way to validate it.
What You Should Do
Ask your carrier for the list of your top 20 most expensive medications.
If you get pushback, that tells you everything you need to know. That is the data you are paying for but not seeing.
We help self-funded employers find these savings without disrupting coverage. Employees stay on the same medications. No changes to their care. Just someone actually doing the analysis.
If you want to see what a pharmacy assessment looks like for your plan, DM me for more information.