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

Complete this simple form & we'll email you a copy of the report.

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© Copyright 2020 Scripta Insights, Inc. 

Scripta™ is neither a pharmacy nor a doctor. The benefit service does not tell you what drug to take and does not participate in the drug selection process. Only your physician can determine the medications that are right for you. These alternative medications are options for less costly drugs that physicians may prescribe in place of the medications you are taking now. Scripta has reviewed your current medications only for the purpose of identifying potential cost savings for you to consider with your physician. Scripta has not analyzed the effectiveness or other therapeutic aspects of these medication alternatives. Accordingly, this report and any other forms of communication received from Scripta are not, nor should they be interpreted as, any form of treatment, drug regimen review, or provision of counseling or consultation by a prescriber, pharmacist or pharmacy. Do not stop taking your medication, change your medication, or start taking a new medication without being directed to do so by your physician and filling the prescription under the oversight of a licensed pharmacist. The alternatives set forth above may not be equivalent to your current medication, may interact adversely with your other medications, may not be indicated in light of your other conditions, may cause different or severe side effects, or may be less effective at treating your condition. Medication prices are approximate based on information provided by your pharmacy benefits manager, insurance plans, and/or employer, and may vary from pharmacy to pharmacy. Check with your insurance plan to obtain a full list of pharmacies where your prescriptions can be filled. All information herein is HIPAA protected, treated as highly confidential, and never shared with your employer.

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