The real reasons prescription drug prices are rising — and what employers can do

Across the nation, employers are seeing a steady rise in pharmacy costs. Factors like increased demand for specialty medications, new drugs entering the market, and off-label use of weight loss medications are pushing costs higher than ever.

At Univera Healthcare, we understand these challenges — and we’re here to help. Our holistic approach is built to help manage rising costs through proven clinical strategies, waste reduction and value-based solutions. The result? Better health outcomes for employees and real savings for businesses.  

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. Univera Healthcare 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 month. That means better outcomes for your employees—and more value for your business.

A holistic approach to care

When it comes to your pharmacy benefits, it’s not just about filling prescriptions—it’s about taking care of your people. At Univera Healthcare, we focus on solutions that support businesses and their people.

With the right programs in place, employers can worry less about rising costs and feel confident knowing your team is getting the care they need. After all, when pharmacy care works better, everybody benefits.