U.S. pharmaceutical expenditures rose 12.7% in 2025 to $915.2 billion, according to a recent analysis in the American Journal of Health-System Pharmacy. Utilization drove most of the growth, led by high-cost therapies such as tirzepatide, semaglutide, and apixaban.
For employers, this underscores a key point: controlling pharmacy costs requires more than rebates and discounts. As utilization of high-cost medications rises, plans need strategies that promote clinically appropriate use, improve net costs, and target the drugs driving spend.
MedBen Rx applies that broader approach through:
- Transparent pricing via our Acquisition Cost Index (ACI) drug pricing, which bases reimbursement on actual pharmacy acquisition costs and removes hidden margins. In 2025, clients spent 25.1% less per employee than those using other PBMs.
- Formulary strategies that guide members to cost-effective options while preserving access to appropriate therapies.
- Specialty drug controls through Benefit Preservation, which reduced specialty spend by an average of 31.9% via patient assistance programs and coupon management.
- Biosimilar adoption support that cut clients’ average monthly spend on these medications by 78%.
Together, these strategies delivered a five-year pharmacy cost trend of 4.6% for MedBen Rx clients — versus 8.6% for those using other PBMs. To learn more, see our 2026 Client Report.