How Lowering Prescription Drug Costs Can Help Employers

Did you know the fastest growing component of health benefit costs continues to be prescription drugs? In fact, 2025 saw an average increase of 9.4% in prescription drug costs, the highest jump in the last decade*. This means higher prices and tighter budgets to navigate for employers, which could present more challenges to employees surrounding medication adherence.

The good news is that employers do have options when it comes to lowering prescription drug costs, and that’s why we built our pharmacy solutions—to help you connect the dots to optimal savings and reduce pharmacy spending.

Why Prescription Drug Costs Rise

There are many reasons why prescription drug costs can increase. Drug development is long and expensive, patent rules significantly limit competition, supply chain issues slow down production and drive prices up, and even strong pharmacy benefit management programs can miss costly prescribing patterns.

Drug Development

Creating a new medication takes years of research, clinical trials and safety testing. Only a small number of drugs make it through the full process. Because of these high expenses, manufacturers set higher prices when a drug reaches the market. These prices are then passed on to health plans, employers and employees.

Patent Protections

Patent protections give a manufacturer exclusive right to sell a drug for many years. During this time, no generic alternative can enter the market. With no competition, the medication stays expensive. This creates higher costs for health plans and employers.

Supply Chain

The supply chain includes manufacturing, packaging, wholesalers, pharmacy benefit managers, pharmacies and delivery. Each step adds cost. Delays, shortages or global supply issues can raise prices even more. When this happens, employers often see the impact on their overall drug spend.

Additional Factors

Other issues contribute to increased costs. These include duplicative therapies, incorrect doses, medication waste and limited clinical management options. The use of prescription drug therapies has also increased over the last two decades. Without specialized oversight, unnecessary costs slip through the cracks. Over time, small inefficiencies add up and create a large impact on employer budgets.

How Rx Concierge Can Lower Prescription Drug Costs

Even with rising prices and growing utilization, employers have several ways to reduce spending and improve employee access to medication. These include switching to generics, reviewing and updating benefit design, using discount programs and adding hands-on clinical support.

Our Rx Concierge solution layers on top of any existing pharmacy benefit structure and strengthens what’s already in place without changing formularies, adding claim restrictions, or disrupting members. We provide thoughtful clinical guidance that improves outcomes and reduces spend, ensuring the best care.

Here are the most effective strategies employers can utilize to lower prescription drug costs:

Switch to Generic Medications

Generic medications work the same as brand-name drugs and often cost far less. Many employees don’t know when a generic option is available, and prescribers may not always have time to thoroughly review cost-effective options.

Rx Concierge helps by reviewing real claims data, identifying alternatives and working directly with prescribers. When a safe and effective generic alternative is appropriate, our pharmacist discusses it with the provider. If the provider and their patient both agree to the change, the prescription is changed by the prescriber, with no disruption. For employers, this lowers pharmacy spend while supporting better outcomes.

Review Coverage Options

Even when employers have solid pharmacy plan design, gaps may still occur. Formulary optimization, claim edits and utilization management are important, but these measures cannot capture everything. High-cost medications, dosing issues and suboptimal regimens can still make their way through.

This is why brokers often look for added clinical protection. Rx Concierge strengthens existing pharmacy benefit management by giving employers an extra layer of review, using advanced data and clinical expertise to catch missed opportunities and support better decisions.

Use Rx Discount/Assistance Programs

Discount programs and patient assistance resources can significantly lower drug costs. Through an enhancement to Rx Concierge, we take affordability even further by partnering with companies like Mark Cuban Cost Plug Drugs, which aims to eliminate middlemen and offer competitive and transparent drug pricing.

If an employee’s medication is on our curated list of commonly used drugs, they may receive it for $0 through our program, with no copay at all. Eligible members can also earn a $250 gift card for switching select prescriptions. Our pharmacists handle the full process, contacting the member, coordinating with the doctor, moving the prescription and ensuring home delivery.

For groups not enrolled in Rx Concierge, RxCostConnect offers direct access to Cost Plus pricing and delivery as a simple, stand-alone option.

Rely on Pharmacy Benefit Management

Employers must rely on their pharmacy benefit manager to help manage drug costs. Pharmacy benefit managers offer many valuable tools, but strong clinical insight often requires a more hands-on approach. Rx Concierge is not a pharmacy benefit manager and has no financial ties to manufacturers or networks.

Instead, the program works with any pharmacy benefit manager, any broker, and any health insurance company to support safer, more cost-effective prescribing. By speaking directly with providers, our pharmacists help reduce risk, improve member experience and lower spend—all without changing coverage.

Other Ways Employers Can Reduce Costs

Employers can also help lower prescription costs by encouraging medication adherence, offering wellness education, and reviewing specialty drug use more closely. Strong data insights, ongoing clinical review, and transparent communication with employees all support better outcomes.

Lowering Prescription Drug Costs: Redefining Healthcare

Prescription drug costs rise because of growing use, development and manufacturing expenses, distribution considerations and effective marketing.  However, employers and brokers have many ways to deliver savings—from promoting generics to leveraging innovative cost-containment programs and strengthening pharmacy solutions that support clinical oversight.

Rx Concierge by Candesa Pharmacy Solutions is redefining how employers manage pharmacy care. Our experts are here to work with you to find and implement solutions that will help shine a light on opportunities to enhance care and drive down pharmacy spend. With guaranteed savings, no disruption to members and thoughtful clinician-led support, we help companies offer better access at a lower cost.

If you’re ready to reduce pharmacy spend and support better outcomes for your employees, explore our solutions today. Whatever your needs may be, we’re here to support you.

*Source: Mercer. 

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