CLEARly Beneficial: S2E11
The Hidden Cost of Pharmacy: What Employers Need to Know
The Hidden Cost of Pharmacy: What Employers Need to Know
Pharmacy benefits have quietly become one of the largest and least understood drivers of healthcare spend. What was once 12–15% of total healthcare costs has grown to 30–50% for many employers today. Yet despite that growth, much of the system remains opaque, with dollars flowing through a complex supply chain of manufacturers, PBMs, and intermediaries, often without full visibility into where that money actually goes.
On the S2E11 episode of the CLEARly Beneficial podcast, Joey Dizenhouse, President & CEO of SlateRx, breaks down a fundamental issue at the center of the problem: misaligned incentives. In many traditional models, organizations managing pharmacy benefits generate more revenue as drug spend increases. That raises an important question for plan sponsors, can a partner truly act in your best interest if the more you spend, the more they make?
Beyond transparency, Joey outlines a more complete way to think about pharmacy strategy. Employers need to consider the full picture: 1) unit cost, 2) utilization, 3) drug mix, 4) volatility from high-cost claims, and 5) engagement. Ignoring any one of these levers can lead to significant and unpredictable plan risk.
Ultimately, the takeaway is clear: pharmacy can no longer be treated as a passive line item. Employers that take a more active, informed approach, demanding more from their partners, are far better positioned to manage costs and improve outcomes in an increasingly complex landscape.
Want to hear Joey’s episode?
Listen to Joey’s full conversation on S2E11 of the CLEARly Beneficial podcast, “The Hidden Cost of Pharmacy,” to hear more insights on PBM alignment, how rebates really work, where GLP-1s are headed, and what employers can do right now to take control of their pharmacy spend.
Listen to the full episode (S2E11) on any of your favorite podcast channels or find it here: https://clearhcs.com/
