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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 pharmacy benefits must evolve
Pharmacy benefits have played a critical role in managing drug costs for decades. But today’s environment—defined by rising spend concentration, complex therapies, and heightened expectations for transparency—demands a more adaptive approach.
Employers are increasingly seeking pharmacy benefit strategies that reduce volatility, improve clarity earlier in the experience, and better align affordability with access and outcomes.
Evernorth SignatureSM Pharmacy Benefits is responding to this shift by evolving pharmacy benefit design—building on decades of innovation while reimagining how affordability, access, and experience work together. Change won’t happen overnight, but starting now is critical for long‑term sustainability.
Bringing greater clarity to health care costs
Ashley Holzworth-Nash, Pharm D, Vice President, Evernorth Product Strategy and Solutions shares how we are helping members make more informed care decisions through greater price transparency, personalized guidance, and tools that simplify affordability.
Affordability is about predictability—not just cost
As cost pressures intensify and drug trends accelerate, employers are reassessing what affordability really means. Increasingly, affordability is less about chasing the lowest number and more about creating predictability, stability, and confidence in benefit design decisions.
This shift reflects a growing recognition that volatility itself has become a strategic risk—one that affects not only cost, but experience, trust, and long‑term sustainability.
Read below to learn how evolving pharmacy benefit models are helping consultants give clients more confidence in an increasingly volatile market.
A broader market perspective on affordability
For a broader lens on the forces shaping affordability, Brian Evanko, President and Chief Operating Officer of The Cigna Group®, shares his perspective on U.S. health care dynamics—including pharmacy benefits and patient care—and what these shifts mean for benefit decision‑making.
Transformative pharmacy strategies
for a changing market
Lowering costs in a high-stakes drug environment
Just 10% of branded medications drive 88% of pharmacy costs, creating an unsustainable cost curve for employers.1
Improving transparency to build trust
61% of employers with 500+ employees are are actively considering alternative strategies for providing or managing pharmacy benefits, motivated by increasing costs and a need for improved transparency and oversight.2
Supporting local pharmacies as frontline health partners
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.3
Key consultant takeaway:
Today’s leading consultants help clients navigate rising pharmacy complexity through sustainable cost strategies, transparent partnerships and integrated community care solutions that drive better outcomes.
The future of pharmacy benefits isn’t just about managing drug costs
—it’s about restoring trust, empowering patients, and delivering measurable health and economic value. These changes take time, but starting now is critical for sustainability.
Explore how Evernorth’s pharmacy benefit model is evolving to deliver more predictable affordability.
Sources
- Association for Accessible Medicines, 2025 Savings report. 2025.
- Mercer, Employers are evaluating alternatives to traditional PBM contracts. 2025.
- Evernorth, Transforming pharmacy reimbursement to strengthen community health. 2025.