A Dose of Clarity

As we wrap up 2025, the pharmacy benefit management (PBM) landscape is advancing rapidly. For brokers, employers, and third party administrators (TPAs), the key to staying ahead is recognizing not just traditional cost drivers but emerging disruptors: High-cost specialty and gene/cell therapies Global supply chain/tariff dynamics New regulatory pressure Rescription is built for the future of pharmacy benefits and this state-of-the-industry report outlines what matters now, an

Learn what to look for in a PBM partner, from transparency to aligned incentives, to protect your plan and build towards a long-term goal.

At Rescription, we see firsthand how Pharmacy Benefit Managers (PBMs) affect the healthcare landscape—and it’s clear that reform is long overdue. Like Rep. Buddy Carter (R-GA), Sen. James Lankford (R-OK), Rep. Nanette Barragan (D-CA), and other bipartisan lawmakers who have recently rallied for PBM reform, we believe that addressing the inefficiencies and profit-driven practices of PBMs is critical for creating a more transparent, affordable, and patient-centered healthcare s

As the season for PBM (Pharmacy Benefit Manager) renewals and evaluations arrives, a familiar sense of unease looms over employers' desks. Each year, net costs surge at an unsustainable pace, casting a shadow of concern over companies. Do you ever find yourself exasperated by the constant assurance of higher rebates, only to witness your expenses rise in tandem, leaving your bottom line untouched? If so, Rescription stands apart by honing in on top-line cost management – the

In an era where employer health and benefit costs are on the rise, the importance of reevaluating benefit offerings has never been clearer. With the looming prospect of escalating costs, employers are seeking comprehensive solutions that go beyond mere integration of disparate point solutions, aiming for enhanced ROI and employee satisfaction. Effective cost containment strategies stand as a pivotal complement to comprehensive benefits solutions. As employers navigate the lan

One of the biggest health insurers in the country, Blue Shield of California, has decided to drop CVS Health’s Caremark as their pharmacy benefit manager. This has "sent jitters through Wall Street," as reflected by the drop in each of the PBM Big Three’s (CVS, Cigna, and UnitedHealth) stock prices. Rather than working with Caremark, Blue Shield has decided to use Amazon, Mark Cuban’s Cost Plus, and several others to manage prescription drug costs in a way that is different f

A PBM is a third-party entity that operates as an intermediary between health insurance plans, pharmacies, and prescription drug manufacturers. The primary objective of PBMs is to streamline the prescription drug distribution process, enhance cost-effectiveness, and ensure that patients have access to necessary medications. They negotiate contracts with drug manufacturers, establish drug formularies, process prescription claims, and administer pharmacy networks for health ins

In the realm of prescription drug pricing transparency, the utilization of NADAC (National Average Drug Acquisition Cost) pricing shines as a superior alternative to the commonly employed AWP (Average Wholesale Price) pricing model. NADAC pricing offers distinct benefits that foster a clearer understanding of medication costs for both healthcare providers and patients. NADAC pricing stands out due to its inherent transparency. Unlike AWP, NADAC prices are publicly accessible

Weight loss drugs are no doubt trending, and they may be the answer for a growing number of people struggling with their weight, but the costs are high for self-insured employers. According to the Centers for Disease Control and Prevention, about 74 percent of adults in the United States are overweight and some may be turning to the popular drug Ozempic, an FDA-approved prescription medication for people with type 2 diabetes. Although unofficially termed “weight loss drugs,”