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The rising cost of prescription medication puts pressure on patients and pharmacists alike. Organizations use countless resources to find creative ways to reduce spend while maintaining access and adherence. When advising self-insured employers, understanding how to save on prescription medications has become a strategic advantage.

By leveraging cost-effective medication strategies and the right pharmacy benefit management tools, organizations can create win-win cost savings that improve member satisfaction and performance outcomes.

Key Takeaways

• Technology-driven pharmacy benefit management can reduce prescription spend without reducing quality.
• Encouraging generic substitution, formulary optimization, and patient engagement are key to cost control.
• Data-driven insights help pharmacists and plan sponsors design sustainable drug benefit programs.

Smart Strategies to Lower Prescription Costs

Promote Generic and Therapeutic Alternatives

Encouraging the use of generic medications is one of the simplest ways to reduce the cost of prescription medications. Pharmacists can proactively consult patients about lower-cost alternatives that are equally effective. Employers and brokers can reinforce these options by structuring benefits that incentivize generic use.

Modern pharmacy benefit management platforms automate this process by flagging brand-name prescriptions that have lower-cost alternatives. This helps them guide both patients and providers toward better-value choices.

Utilize Real-Time Prescription Benefit Tools

Real-time cost transparency tools help pharmacists inform patients of out-of-pocket costs before prescriptions are filled. These tools enable better decisions at the point of sale—such as switching to a more affordable dosage form or supply quantity.

These tools give both the pharmacist and plan sponsor a clearer view of what drives cost increases and where savings opportunities lie.

With tools such as Waltz Connect, we make this process even smoother. Waltz Connect enhances this process significantly. It is a specialty-drug savings platform that integrates automated prescription routing technology with a dynamic marketplace featuring numerous URAC-accredited specialty pharmacies. Waltz Connect assesses clinical requirements, pricing, and patient eligibility to determine the most cost-effective and clinically suitable pharmacy for each member. This AI-driven, real-time optimization ensures clinical continuity while providing significant value.

Optimize the Formulary

A well-managed formulary balances clinically driven coverage with cost control. When powered by intelligent software, formularies can dynamically adjust based on drug performance, availability, and negotiated discounts.

Formularies are crucial as they guide both prescribers and patients in selecting effective yet cost-efficient medication options. By creating and managing formularies, PBMs can guide beneficiaries towards cost-effective medications, often resulting in substantial savings. Formulary management is a dynamic process that involves regular reviews to include new, effective, and affordable medications.

At Serve You Rx, we offer clients three formulary options to help strike the balance between cost savings and member access.

• Biosimilar Advantage Formulary – promotes the adoption of biosimilars and improves cost-effectiveness for plan members
• Select Formulary – our preferred formulary option
• Standard Formulary – our most flexible formulary option

Collaboration Between Pharmacists and PBMs

Encourage Patient Engagement

Pharmacists are trusted advisors who can increase medication adherence, a key factor in preventing unnecessary cost escalation. Technology enhances their efforts by improving communication channels and reporting dashboards that highlight at-risk patients or cost-saving substitution opportunities.

Monitor Utilization with Advanced Analytics

Data analytics can uncover usage patterns and outliers that lead to higher spending. By tracking metrics such as refill frequency and geographic cost variation, PBMs and benefit consultants can identify where plan design tweaks or education initiatives could reduce overspending.

Software simplifies this process by surfacing actionable insights directly within client dashboards.

Improve Plan Transparency

Opacity in drug pricing can mask proper cost drivers. Transparent PBMs ensure employers know exactly where their money goes, from ingredient costs to rebates and administrative fees. With clearer visibility, brokers and CPAs can confidently compare program performance or negotiate improvements.

Data-Driven PBM Solutions for Sustainable Savings

Reducing the cost of prescription medication is a process of continuous optimization. When pharmacists, patients, and benefit managers work together with the support of an advanced software solution, consistent savings and better outcomes follow.

A PBM helps benefit consultants and plan sponsors implement flexible, transparent, and data-informed cost management strategies tailored to each group’s unique goals.

Ready to Transform Your Pharmacy Benefits?

Take control of rising prescription costs with Serve You Rx’s innovative PBM solutions. Our programs, partnerships, and strategies help brokers, consultants, and plan sponsors design and manage benefit programs that deliver value—without compromising member care.

Learn more about Serve You Rx’s solutions for cost-effective pharmacy benefit management.

About Serve You Rx®   
Serve You Rx is a full-service pharmacy benefit manager (PBM) with unquestionable flexibility and an unwavering commitment to doing what’s best for its clients. With a fervent focus on those it serves, including insurance brokers, consultants, third-party administrators, and their clients, Serve You Rx delivers exceptional service and tailored, cost-effective benefit solutions. Independent and privately held for nearly 40 years, Serve You Rx can implement new groups in 30 days or less and say “yes” to a wide variety of viable solutions. Known for its adaptability, quality, and client-centricity, Serve You Rx aims to be a benchmark for better client service.