You closed out the year, finalized your renewal, and put benefits back on the shelf until fall.
Here’s what most employers miss: Q1 is when you should be looking at pharmacy.
For many employers, prescription drugs represent 25% or more of total spend. In some plans, one medication can swing your renewal by double digits.
Here’s a real example:
Last year, we reviewed a plan where two siblings were on the same high-cost drug. That one medication was costing the employer $1,500,000 every year.
We analyzed the data. We helped the family source the same drug for $500,000.
Same medication. Same dosage. $1,000,000 in savings. No disruption to the employees.
Why doesn’t your advisor show you this?
Because most advisors in our space are either:
- Too lazy to do the actual work
- Making money from PBM relationships you don’t know about
- Lacking the knowledge to unbundle and analyze pharmacy spend properly
Either the big carrier owns the PBM or the PBM own the carrier. Either way, the pharmacy side is typically the most profitable part of the business – for them, not you.
Even independent TPAs often have ownership interests in “preferred” PBMs. That’s a conflict you’re paying for.
What you should do right now:
Take a fresh look at your pharmacy spend now.
A proper pharmacy assessment shows you:
- What’s actually driving your costs
- Which medications are silently inflating your renewal
- Where you can find meaningful savings without changing employee prescriptions
- How to make smart decisions before renewal pressure hits
Your employees shouldn’t have to choose between skipping a dose or paying $2,500 out of pocket. And you shouldn’t be overpaying by hundreds of thousands – or millions – because your advisor won’t do the work.
You have choices and options.
Ask the questions.
Push your advisor.
If they can’t show you this level of detail, you’re working with the wrong people.
DM me for more information.