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Lead the change: Evolve pharmacy benefits for tomorrow
The pharmacy benefit model is evolving. Here’s why—and how you can lead the way
Why it’s time to evolve
The pharmacy benefit model has served employers well for decades, but today’s drug landscape demands a new approach. Rising costs, complex therapies, and growing expectations for transparency are reshaping what employers need.
Evernorth® is driving this evolution by building on a legacy of pharmacy benefit innovation—such as pioneering solutions for specialty drug management and integrated care—and reimagining a model with customer-first strategies that prioritize affordability and access. Change won’t happen overnight, but starting now is critical for sustainability and better health outcomes.
Transformative pharmacy strategies
for a changing market
Lowering costs in a high-stakes drug environment
In 2024, for the first time traditional drug spend increases outpaced both specialty and overall drug-spending growth.1 Today, just 10% of branded medications drive 88% of pharmacy costs, creating an unsustainable cost curve for employers. 2
Simultaneously employers face mounting financial risk as breakthrough therapies enter the market at unprecedented prices and demand continues to rise.
Consultant opportunity: Guide clients to pharmacy benefit solutions that address the full spectrum of costs—traditional, specialty, and catastrophic—helping them achieve predictability and sustainability in their pharmacy spend.
Improving transparency to build trust
61% of employers with more than 500 employees are actively considering alternative strategies for providing or managing pharmacy benefits, motivated by increasing costs and a need for improved transparency and oversight.3 Notably, 60% of employers and consumers define transparency as "cost clarity."4
Consultant opportunity: Transparency isn’t just a compliance issue, it’s a differentiator. Consultants who advocate for clear pricing, real-time data, and open communication elevate their role from vendor manager to strategic health advisor.
Supporting local pharmacies as frontline health partners
With physician shortages and long wait times, local pharmacies are becoming essential access points for care. Nearly 90% of the U.S. population lives within five miles of a pharmacy, making local pharmacies among the most accessible health care resources in the country.5 Pharmacists agree—93% believe they should have a role in educating patients and 90% feel they should have a role in delivering clinical care.6
Consultant opportunity: Help clients leverage the accessibility and expertise of local pharmacies to close care gaps, improve member experience, and support whole-person health.
Sources
- Evernorth, 2025 Pharmacy in Focus report, Navigating the GLP-1 conundrum: Demand, cost, and sustainability. 2025.
- Association for Accessible Medicines, 2025 Savings report. 2025.
- Mercer, Employers are evaluating alternatives to traditional PBM contracts. 2025.
- Evernorth, Annual buyer insight survey. 2025.
- Evernorth, Transforming pharmacy reimbursement to strengthen community health. 2025.
- Evernorth, 2025 Pharmacy in Focus survey. 2025.