Disclosure Won. Now What?

A PBM can provide a clearer view into its economics and still leave the employer with rapidly rising specialty spending. 

A contract can pass through rebates while members struggle to begin clinically appropriate therapy. 

A reporting package can show detailed data without giving the plan enough flexibility to respond to what the information shows. 

That distinction matters because pharmacy costs are not becoming easier to manage. Business Group on Health reports that pharmacy now represents 25% of employers’ total healthcare spend and estimates employer drug costs will rise 12% in 2026. ²  

Seeing the problem matters. Understanding the driver matters too. So does the ability to change course. 

A useful pharmacy strategy gives the plan sponsor answers to questions such as: 

• Which therapies and populations are driving cost?  
• What is the final net cost after rebates, fees, and other payments?  
• Why was a particular formulary or pharmacy channel selected?  
• Where are members encountering avoidable barriers?  
• Did an intervention produce a measurable result?  

Better visibility makes those answers easier to find. 

The National Alliance’s 2026 Pulse of the Purchaser survey reinforces that point. Employers with complete medical claim-level access reported using an average of 11.9 high-value purchasing strategies, compared with 7.9 among employers with limited or no complete access.3 

Data access alone does not guarantee a better result. But it gives employers more ability to identify a problem, evaluate the options and act. 

That is why visibility is only the beginning.