5 smart ways to lower prescription costs without cutting benefits

Prescription drug prices keep climbing, putting pressure on businesses and employees alike. But here’s the good news: cutting costs doesn’t have to mean cutting benefits. With a few smart strategies, you can keep expenses in check while making sure your team gets the medications they need. When you’re there to help care for your people, they’ll be there for your business.

Through these five proven approaches, Univera Healthcare can help you connect the dots for you and your employees while improving care and helping address rising costs for everyone.

1. Smart formulary management

A well-structured formulary keeps costs down while ensuring employees have access to the medications they need. Having a rigorous review process in place helps ensure drugs are placed appropriately on our formulary, weighing clinical outcomes and cost-effectiveness. Prior authorizations, managed by unbiased pharmacists, also help prevent unnecessary spending while maintaining quality care.

2. Reducing waste and unnecessary spending

One of the biggest drivers of rising health care costs is pharmacy waste. Employers can tackle this with strategies like high-cost claim reviews, splitting initial fills of expensive specialty oncology medications, and promoting value-based drug solutions. Programs like our dedicated Pharmacy Special Investigations Unit (SIU) mitigate risk for employer groups by stopping potentially fraudulent activities as they occur.

3. Managing the growing GLP-1 trend

GLP-1 medications, originally approved for diabetes, have also seen a surge in use for weight loss. While these medications can be beneficial for the right patients, inappropriate prescriptions drive up costs. A structured prior authorization process ensures that GLP-1 prescriptions align with medical guidelines, preventing unnecessary spending while ensuring appropriate patient access. Businesses using this approach have already seen significant savings. Groups leveraging our Univera Healthcare formularies had an average $13.64 PMPM savings on GLP-1 weight loss drugs compared to that of a national PBM formulary.

4. Optimizing specialty drug benefits

Specialty drugs account for a large portion of pharmacy expenses, increasing medical costs, but a strategic shift can help. Shifting certain specialty medications from the medical benefit to the pharmacy benefit unlocks lower net costs—helping you save money while keeping care uninterrupted for employees.

5. Better cancer care management

Advancements in cancer treatments bring better outcomes—but also rising costs. Employers can manage these expenses by leveraging strategic partnerships that provide evidence-based oncology care. High-cost claims can be reviewed with expert input to ensure employees receive the best treatment at the lowest cost.

Take control of pharmacy costs

Employers don’t have to choose between saving money and supporting employee health. By implementing these five strategies, businesses can create a sustainable pharmacy benefit plan that benefits them and their employees.

Together, these five strategies make up our core pharmacy suite, which helps employers save an average of $27.77 PMPM². Want to explore cost-saving opportunities for your organization? Visit UniveraForBusiness.com or contact your account representative today.

1 Based on 2024 Health Plan Data 2 Based on 2023-2024 Health Plan Claims Data.