The latest Pulse of the Purchaser survey provides critical insights for self-insured employers grappling with the evolving healthcare landscape. Below are the five most impactful takeaways from the survey, highlighting areas where employers can optimize their pharmacy benefits strategies.

1. Drug Prices Are a Primary Concern
   With nearly 100% of respondents identifying drug prices as a significant threat to healthcare affordability, managing prescription costs is paramount. Employers should consider renegotiating PBM contracts to ensure transparency in pricing, rebates, and fees. Implementing a value-based formulary instead of a rebate-driven one can yield significant cost savings.
2. Interest in PBM Reform Is Rising
   More than half of employers plan to reconsider their PBM within the next three years. The most sought-after reforms include full revenue disclosure and flexibility in formulary customization without financial penalties. By adopting these strategies, employers can regain control over drug utilization and ensure alignment with fiduciary responsibilities.
3. High-Cost Claims Demand New Strategies
   High-cost claims remain a major threat to affordability. Strategies such as site-of-care redirection (e.g., home infusion) and enhanced case management are seeing increased adoption. Employers can mitigate the budgetary impact of large claims by incorporating precision medicine and partnering with centers of excellence.
4. GLP-1 Coverage and Obesity Management
   Coverage for GLP-1 drugs and other anti-obesity medications is gaining traction. However, cost-mitigation strategies, such as limiting access to high-risk populations and covering compounded alternatives, are crucial. Employers offering obesity management programs, including lifestyle interventions and bariatric surgery, are ahead of the curve in controlling related healthcare costs.
5. Transparency and Fiduciary Responsibility in Focus
   Fiduciary duties are increasingly under the spotlight, with employers expressing concerns about the integrity and conflicts in PBM and hospital billing practices. Ensuring independent audit rights and retaining ownership of all health plan data can strengthen employers’ fiduciary oversight and drive down unnecessary expenses.

By acting on these insights, self-insured employers can better manage rising healthcare costs while safeguarding the health and well-being of their workforce.