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Healthcare is a complex supply chain and many medical devices, pharmaceuticals, and even basic supplies like syringes, gloves, and diagnostic equipment are imported. When tariffs are imposed on foreign goods (especially from major suppliers like China, India, or the EU), the cost of these essentials increases.
As prescription drug costs continue growing and pricey new pharmaceuticals add to health plans’ cost burdens, some carriers are starting to reduce the number of medications they’ll cover and are imposing new barriers to accessing the most expensive ones. On top of it all, pharmaceuticals are getting more expensive.
The decisions can have a ripple effect into other areas, such as: Increased Health Insurance Costs: Premium increases directly impact the budget and total health spending that is dedicated to employee benefit programs and services. Evaluate pharmacy benefit management strategies for cost efficiency.
The changes mean some or many of your employees will see significant reductions in their pharmaceutical outlays, particularly if they have high copays or deductibles. The moves come after the Inflation Reduction Act, signed into law in 2022, capped out-of-pocket insulin costs for seniors on Medicare at $35 per month.
And it’s no surprise that specialty drugs are eating up a huge amount of total drug spending — whether it’s an oncology drug, a drug to treat a rare condition, or a biologic with multiple indications, the annual cost of a single specialty treatment can easily run into five, six or even seven figures. Focus on fundamentals for Rx cost savings.
Many employers, especially those that are self-funded, encourage this type of behavior since it can help them control costs and ultimately save significant dollars for both the company and its employees. Buying larger quantities at a time generally reduces the per-dose cost of drugs. Bulk Buying Prescription Drugs. Medication Samples.
Employer Refuses Reimbursement Request When the claimant provided his law firm employer with the CBD oil prescription and receipts for its purchase, the law firm refused to reimburse the claimant’s out-of-pocket CBD oil expenses on the basis that CBD oil was not a pharmaceutical drug. LEXIS 192, No. 14, 2023)].
Reducing out-of-pocketcost-sharing for insulin does mean payers and insurers may be covering a greater share of the costs. However, some of those costs may be offset by increased medication adherence and reduced hospitalization rates, which would end up saving payers money in the long run.
The high courts ruling settles a long-running dispute that began when the claimanta workers compensation attorney appearing pro sesought reimbursement for the out-of-pocketcost of CBD oil recommended by his treating physician as a substitute for higher doses of opioid medication. LEXIS 389 (Mar. 20, 2025)].
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