Beyond List Price: What Employers Need to know to Combat Skyrocketing Drug Costs

Pharmacy now accounts for nearly a quarter of what employers spend on health care, and it's growing at almost twice the rate of medical costs. Most plan sponsors have responded with tighter prior authorization and a harder look at their PBM. Those steps help. But they don't touch the decision that sets most drug costs in motion, which is the prescription a doctor chooses to write.

In this session, Kirk Czonstka, Garner's SVP of Strategic Alliances and Partnerships, and Joe Huston, Garner's VP of Data, draw on Garner's medical and pharmacy claims data to explain what is driving drug spend and where employers still have room to act. You'll hear why biologics make up most pharmacy spend despite being a small share of prescriptions, why biosimilars have not brought prices down the way generics did, and what the coming drug pipeline means for 2027 budgets. Joe also shows how widely doctors differ in their prescribing, from which ones reach for a biosimilar to which ones overprescribe GLP-1s, and puts a dollar figure on what that gap costs a plan.

If you have treated drug spend as a PBM problem, this session makes the case that the prescriber matters just as much, and shows how to find the ones getting it right.