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Self-Insured Employers: Making the Tough Decisions on Pharmacy Benefits

As employees make 2020-2021 healthcare elections, pharmacy benefits decision-makers reveal the method behind their plans. Scripta Insights surveyed 77 HR professionals at self-insured companies in August 2020. Their companies have a range of eligible employees from less than 1,000 to 10,000 or more. Results show employers and members could be saving a lot more on Rx.

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Rx Prices Change Daily,

Rx Plan Design Barely Changes Annually

Only 12% of companies change plan design every year

Employers Don't Have the Tools

They Need to Make Smart Decisions

of employers think they have what they need to properly evaluate their PBM bill.


do not get regular third-party analysis

do not get recommended monthly analysis

do not have regular contact with a pharmacy practice specialist

Employers Want to Spend LESS on Rx,

But Budget for & Accept Large Annual Increases

say lowering pharmacy benefits spend is somewhat or very important to executive leadership & CFOs


would require an increase of 11-20% to reevaluate the plan

See How Quickly it Adds Up

That’s more than $500,000 per year!

Employer Offerings &

Employee Priorities Don’t Match

92% of employers said lowering out-of-pocket costs on Rx is somewhat or very important to their employees

Yet only 31% of employers offer a prescription savings program or coupon service

Smaller Companies Are Missing Out on Savings

Companies with 5,000 or less employees

Companies with 5,001+ employees

Speak regularly with the pharmacy practice specialist at their benefits consultant firm

Offer prescription savings programs or coupons to employees

COVID-19 is Not Changing Pharmacy Benefits Plans

of employers

are not making changes this year

Those making changes are:

Switching PBMs Covering COVID-19 testing at 100% Adjusting copay tiers

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