Analysis of drug pricing trends, PBM reform developments, and employer benefit strategies.
Biosimilars in 2026: How Employers Are Capturing Humira, Stelara, and Eylea Savings Amid PBM Rebate Tensions
Employers in 2026 are saving millions by steering Humira, Stelara, and Eylea claims to biosimilars while confronting PBM rebate pressure and formulary barriers.
How to Evaluate Carve-In PBM Models in 2026: Integrating Medical and Pharmacy Data Without Losing Cost Control
How to assess carve-in PBM models in 2026 by aligning medical and pharmacy data without giving up rebate transparency or cost control.
2026 PBM Spread Pricing Crackdown: How Employers Are Leveraging Pass-Through and Transparent Models to Reclaim Lost Pharmacy Dollars
Employers are ditching spread pricing PBMs in 2026 for transparent, pass-through contracts to recover hidden pharmacy dollars and cut true net costs.
Guide to Managing GLP‑1 Coverage in 2026: Cost Controls, Clinical Criteria, and Communication Strategies for Employer Plans
How employers in 2026 can manage rising GLP‑1 drug costs with smart plan design, clinical criteria, and employee communication strategies.
Generic Substitution Policies That Work: Therapeutic Interchange, Step Therapy, and Quantity Limits Done Right
How to design generic substitution policies that lower pharmacy costs without disrupting employees: best practices for step therapy, therapeutic interchange, and quantity limits.
How to Tailor Formulary Exclusions Without Creating Employee Nightmares
Many mid-size employers exclude drugs to cut pharmacy costs, but blanket exclusions can backfire. Learn how to tailor exclusions for cost and employee impact.
Helping Employees Use Manufacturer Copay Assistance Programs: The Employer Guide to Patient Assistance Navigation
Practical steps for HR and benefits leaders to help employees access manufacturer drug copay assistance and patient assistance programs, with real-world examples.
Pharmacy Benefit Carve-Out from Medical: Real-World Wins, Pain Points, and How to Decide
Should you carve pharmacy out from your medical plan? Real numbers, pitfalls, and the exact steps to decide if a carve-out saves money for your company.
Mandatory Mail-Order Pharmacy: Real Savings, Real Trade-Offs, and How to Get It Right
Mandatory mail-order pharmacy programs can deliver savings, but real-world data shows trade-offs with employee satisfaction. Here’s what works, what doesn’t, and how to decide.
The Hidden Costs of Prior Authorization: When Saying Yes Can Save More Than Saying No
Prior authorizations may control drug spend, but hidden costs from administrative burden and treatment delays can quietly erode expected savings for employers.
Evaluating Pharmacy Benefit Consultants: Spotting Real Advice vs a PBM Sales Pitch
How to tell real pharmacy benefits consulting apart from PBM sales spin, with hard questions, benchmarks, and one must-do step for HR and benefit managers.
CMS Transparency in Coverage: What Machine-Readable Files Reveal About Your Pharmacy Benefit
CMS Transparency in Coverage files expose your pharmacy pricing and PBM contract quirks. Here’s what employers see, and how to use (or misuse) the data.
Communicating Pharmacy Benefit Changes to Employees Without Causing a Revolt: Messaging Templates and Timing
Strategies, templates, and timing tips for HR and benefits leaders to communicate pharmacy benefit changes without employee backlash. Real-world tactics inside.
Formulary Management: How to Cut Pharmacy Spend Without Creating Employee Headaches
Formulary tweaks can trim pharmacy spend by 8-15%, but missteps spark employee noise. Here’s how to save money without spiking complaints or HR headaches.
Running a PBM RFP: The Questions to Ask, the Guarantees to Demand, and How to Compare Apples to Apples
PBM RFPs can get messy fast. Here’s how to ask the right questions, demand real guarantees, and make valid comparisons, without missing the practical details.
Why Where You Infuse Biologics Matters: Site-of-Care Optimization for Employer Health Plans
Site-of-care strategies can cut specialty drug infusion costs by 50% or more. See real numbers, PBM tactics, and pitfalls for mid- and large employers.
Reading the Fine Print: PBM Contract Clauses That Cost Mid-Market Employers $150K–$400K Annually
An overlooked PBM contract clause cost a 550-life manufacturer $312,000 last year. Read how fine print can add six figures to mid-market pharmacy spend.
How to Benchmark Your Pharmacy Spend Against Industry Peers
Learn practical steps to benchmark your pharmacy spend using PMPM, GDR, specialty share, and mail-order rates for informed benefits management.
The Real Cost of Pharmacy Benefits: Why Your PEPM Spend Is Higher Than You Think and Where the Money Leaks
Discover why your pharmacy PEPM spend might be higher than expected and uncover common areas where money leaks in your pharmacy benefits plan.
PBM Rebates Explained: Where Manufacturer Money Actually Goes and How Much Reaches the Plan
PBM rebates can look like big savings, but most employers see far less than manufacturers pay. Here’s how rebate dollars really flow, and what plans can do.