Employee Benefits Market Check Survey: Employer Pharmacy Strategies

Pharmacy costs have risen substantially over the past several years and now account for more than 30% of total medical spend for some employers. Whether it’s due to rising costs of specialty medications, the introduction of GLP-1 drugs, increased utilization by members, or higher list prices from manufacturers, benefit leaders need a well-thought-out plan and vigorous supervision of their pharmacy provider.

We conducted a survey on August 20 to gauge how prepared employers feel regarding their prescription drug plan. The results are summarized below.

*Based on 123 employer respondents.

Key Findings

The survey reveals a clear disconnect for employers. Pharmacy cost pressure is widespread, but confidence, strategic focus, and review discipline have not caught up. It also demonstrates that while GLP-1 drugs create the buzz, plan sponsors don’t view them as either a primary challenge (6.5%) today or a critical strategy for tomorrow (7.6%).

3 in 4 
cite cost as the top pharmacy challenge

Cost pressure dominates. Three-quarters of employers cite cost challenges as their primary issue (including specialty prices, employee affordability, and high-cost gene therapy drugs), yet 6 in 10 are either neutral or unprepared to tackle future cost increases.

Near-term priorities only partly match the pressure. Employee education leads at 26.9%, followed by specialty drug management at 20.2% and PBM contract review at 15.1%. Another 25.2% selected “Other,” signaling a fragmented response rather than a single dominant strategy. Continuous employee education is important, and we see it as a reported theme in our other surveys, however employers must focus on other tactics to make a tangible impact.

The review gap creates urgency and opportunity. Only half of the respondents have completed a comprehensive strategy review in the past 2 years, while 43% are unsure when the last one occurred.

Taken together, these findings point to a strategy gap more than a data gap: employers recognize pharmacy costs are rising, but many haven’t translated that awareness into a defined plan or a consistent review cadence. Closing that break starts with benchmarking where your organization stands today, prioritizing employee education alongside cost containment, and building a regular review cycle into your plan before the next renewal.

Should you have any questions about this information or would like to discuss your pharmacy strategy, please contact your local Assurex Global adviser.