Why prescription drug prices keep rising — and what employers can do

Prescription drug prices are increasing across the nation and many employers are feeling the effects. Whether it’s the growing demand for specialty medications, new drugs hitting the market, or off-label use of popular medications, these trends are driving costs higher.

At Excellus BlueCross Blue Shield (BCBS), we take a complete, proactive approach to help employers manage rising pharmacy costs while supporting the health and wellbeing of their employees.

Why prices are going up

There are several reasons behind rising prescription drug prices:

• New and expensive medications are being introduced every year. These drugs are often priced higher and not always added to coverage plans right away.
• Specialty drugs are being used more often to treat complex conditions like cancer, diabetes and autoimmune diseases. These treatments can cost thousands of dollars per fill.
• Off-label use of certain drugs, like some GLP-1 medications, is also on the rise. These drugs were created to help people manage diabetes but have been used for weight loss without medical need, leading to higher costs.
• Waste and fraud in prescribing and dispensing medication adds to the problem, especially when high-cost drugs are used instead of more affordable, effective options.

What employers can do

Employers don’t have to face rising costs alone or without options. Excellus BCBS partners with employers to offer smarter pharmacy solutions that improve care and reduce spending. Here’s how:

• Formulary management ensures employees get access to safe, effective medications at the lowest cost.
• GLP-1 trend management prevents overuse and makes sure medications are being used for the right medical reasons.
• Specialty drug optimization moves expensive medications to the pharmacy benefit when it’s more affordable.
• Fraud, waste and abuse detection identifies and stops unnecessary spending before it happens.
• Split-fill programs let members try costly medications in smaller amounts first, reducing waste.

With our core pharmacy suite, we saved employer groups an average of $27.77 per member per month¹. That means better outcomes for your employees—and more value for your business.

A holistic approach to care

At Excellus BCBS, we believe better pharmacy care supports the whole person. Our approach not only lowers costs, but it also improves wellbeing, safety and peace of mind. When pharmacy care works smarter, everybody benefits.

To learn more about how Excellus BCBS can help you manage rising prescription drug prices, explore our core pharmacy suite brochure or reach out to your account representative today.

Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association.

1 Based on 2024 Health Plan Data