How Health Plans Can Take Control of Drug Spend Without Changing PBMs

U.S. prescription drug spending reached $806 billion in 2024—a $50 billion jump and a 10.2% year-over-year increase. High-cost categories like GLP-1s and oncology therapies are driving much of the growth, and health plans are feeling the pressure from all sides. Member groups are demanding more support, better transparency, and relief from cost surprises.

The question most plans are asking isn't whether to act—it's how to act without starting from zero.

The Shift: From Monolithic to Modular

While most health plans aren't changing their PBM relationships outright, nearly all are revisiting how they manage pharmacy costs and engage members. The emerging strategy? Building ecosystems of specialized partners rather than relying solely on a single all-in-one PBM solution.

This modular approach allows plans to layer in capabilities around fulfillment, cost transparency, clinical insight, and member navigation—without requiring a full operational overhaul. It's an incremental evolution that addresses urgent gaps while preserving what's already working.

This is where Scripta fits. As a PBM-agnostic solution, Scripta integrates into your existing pharmacy strategy—whether bundled, hybrid, or unbundled—and adds a layer of intelligence that helps members navigate their options in real time.

What Members Actually Want (And What Scripta Delivers)

Today's member groups expect more than a formulary and a copay. They want:

• Real-time navigation tools that show all available fulfillment paths—retail, mail order, manufacturer coupons, cash pay, and formulary alternatives

• Cost transparency before they fill a prescription, not after

• Clinical validation so they can trust the guidance they're receiving

Scripta's platform delivers on all three. Members receive personalized, clinically reviewed guidance that shows them the lowest-cost, most effective option for every prescription. Plans see measurable results: fewer abandoned prescriptions, better adherence, lower costs, and higher member satisfaction.

The key is simplicity. Scripta's tools are easy to use, clinically credible, and designed to show hard savings from day one.

Progress Without Disruption

Health plans increasingly favor solutions that work within their existing strategies. Scripta is built for this reality. Our technology integrates with your current infrastructure—no rip-and-replace required.

You don't have to choose between your PBM and better outcomes. Scripta works alongside your existing relationships to add transparency, member navigation, and cost control without disrupting day-to-day operations. You can test, measure, and scale what works—on your timeline.

The New Priorities: Control, Experience, and Measurability

As health plans rethink their pharmacy strategies in response to relentless cost growth, three priorities are rising to the top:

1. Cost control that delivers hard savings, not just theoretical efficiencies

2. Better member experiences that reduce confusion and build trust

3. Easy implementation with clear, measurable outcomes

Scripta addresses all three. Our platform plugs into your existing ecosystem, delivers transparent guidance to members at the point of decision, and provides clear reporting on savings and engagement. You get results you can measure without the complexity of a multi-year transformation project.

This isn't about starting from scratch. It's about building on what's working and navigating through what's not—with a partner that makes progress possible.

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Ready to take control of pharmacy costs without the disruption? Scripta Insights helps health plans deliver transparent, clinically validated member navigation that integrates seamlessly into any PBM strategy. Let's talk about what's possible for your plan.