The Quiet Cost Creep in Pharmacy Spend: Don’t Miss the Forest for the GLP-1s

GLP-1s like Wegovy and Zepbound have rightfully taken center stage in ongoing pharmacy strategy discussions. They’re high-cost, high-demand therapies that can significantly reshape the landscape of long-term healthcare spending. Having a clear GLP-1 strategy in place is crucial – without one, health plans will feel the financial consequences fast.

But if we’ve learned anything from managing pharmacy trend, it’s this: there will always be a headliner. GLP-1s today, Humira a few years ago, statins decades ago. The names change, but the pattern is the same.

Meanwhile, the real budget strain often goes unnoticed – hidden in low-profile drugs that quietly inflate your baseline costs. We’re seeing this “cost creep” across dermatology, asthma, ADHD, and migraine—therapeutic areas with high fill volumes and subtle pricing changes that rarely trigger alerts. These are not inappropriate fills, but they’re financially inefficient—and when left unchecked, they add up.

We recently worked closely with a health plan’s pharmacy team to review IQVIA’s drug inflation list and ensure that we included high-impact medications in our member incentive solution. We also cross-referenced inflated drugs with our opportunity data, allowing us to encourage members—through savings alerts and gift cards—to talk to their providers about cost-effective options.

This process uncovered not only expensive new therapies but also long-standing drugs that quietly became overpriced through reformulation or evergreening tactics. While these don’t generate headlines, they do generate claims—week after week, across your population.

The reality is that pharmacy spend management can’t be reactive. Plans need systems in place to spot both the next GLP-1 and the dozens of small-cost changes that quietly drain budgets in the background.

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Scripta Tips: What Health Plans Can Do Now

1. Build a GLP-1 Strategy—Then Look Beyond It Have a clear path for managing high-cost weight loss drugs and a framework to monitor shifting cost drivers over time.
   

2. Use Inflation Data to Prioritize Intervention

   Regularly review IQVIA’s drug inflation list or PBM-provided data to flag where member incentives or alerts could drive change.
   

3. Nudge at the Point of Fill

   Empower members with savings insights before the claim is adjudicated—not just during renewal—using real-time Rx Navigation tools.