Today’s pharmacy benefit model for consultants
Rising specialty drug costs, growing demand for transparency, and increasing pressure to deliver predictable outcomes are reshaping how consultants and their clients evaluate pharmacy benefit solutions.
The pharmacy benefit model is evolving
For years, your clients looked to pharmacy benefit managers to help improve affordability and access. Today, new market dynamics are raising expectations even further. Your clients want greater visibility into costs, more predictable financial outcomes, and solutions to help navigate an increasingly complex pharmacy landscape.
The pharmacy landscape is more complex
The role of pharmacy benefits has never been more important, or more challenging. We’re also seeing these market realities driving broader industry conversations about affordability, transparency, and predictability.
continue to account for a growing share of pharmacy spend.
are entering the market at unprecedented rates.
on employers to balance managing costs with providing access to medications that improve outcomes.
Market forces are accelerating needs.
As pressure grows due to external factors, organizations need to know how their pharmacy benefit is structured, how savings are generated, and how to create greater confidence in future health care spending.
What we’re seeing
Rising specialty costs
Increasing complexity
Employer affordability pressure
Demand for transparency
Need for predictability
A new era of pharmacy benefits
As expectations evolve, benefit models are evolving too. Organizations want greater clarity into their benefits and greater confidence in how their spend will perform over time. While there’s no single path forward, the industry is embracing models that emphasize transparency, predictability, and alignment between cost and outcomes.
The role of consultants
As pharmacy benefit models continue to evolve, consultants are increasingly being asked to help clients understand emerging approaches and evaluate what those changes may mean for their organizations.
Innovation starts with results
As your clients consider the future of pharmacy benefits, performance remains critical. Any discussion about future models must start with a demonstrated ability to help clients manage costs, improve affordability, and deliver value today.
Driving down drug costs: How Express Scripts delivers pharmacy savings for members
For decades, Express Scripts has helped clients navigate pharmacy complexity and improve affordability through clinical expertise, formulary management, and innovative pharmacy strategies. Read how proven approaches delivered measurable value while setting the foundation for future pharmacy benefit innovation.
Preparing for what’s next
The pharmacy benefit landscape will continue to evolve as employers seek greater transparency, affordability, and predictability. For consultants, understanding these shifts will be increasingly important as organizations evaluate future benefit strategies and consider new approaches to managing costs. The future of pharmacy benefits is still being written, but the direction is clear. Organizations need solutions that provide: