By Jim Lantieri, Guest Writer and Summer Intern
As momentum builds in Congress around lowering prescription drug prices, employers may soon see sweeping changes in how medications are priced, covered, and accessed. One notable example is the Global Fairness in Drug Pricing Act, which includes “International Reference Pricing” to align U.S. drug costs with those in countries like Canada and the UK. If passed, this reform could have a lasting impact on healthcare costs for carriers, employers, and employees alike.
At BSI, we’re tracking these developments closely and are already working with our clients to prepare for what’s ahead.
What This Could Mean for Employers
The goal of reform is straightforward: reduce the cost of prescription medications. For employers, the implications go beyond policy.
- Lower pharmacy costs could reduce or stabilize premiums
- Formularies may expand to include drugs that were previously excluded due to cost
- Employees are more likely to adhere to prescribed treatments when prices come down
We’ve seen this kind of shift before. The Inflation Rebate Program, for example, increased scrutiny of Pharmacy Benefit Managers (PBMs) and changed how brokers negotiated on behalf of clients. This round of reform is expected to follow a similar path.
BSI’s Role in Helping You Navigate the Changes
At BSI, we’re focused on translating complex regulatory shifts into a clear strategy for organizations. We’re:
- Working directly with carriers to understand expected formulary updates
- Monitoring PBM contract changes to help ensure cost transparency
- Preparing both HR teams and employees with education tailored to their needs
We recognize that employees at different stages of life have different benefit priorities. Our strategy accounts for that. Learn more in our related article:
Adapting to the Unique Needs of Employees at Different Life Stages
What This Means for Your Workforce
Beyond savings, employers will benefit from stronger workforce outcomes:
- Broader medication access can improve employee health and retention
- Reduced cost-sharing may lead to greater satisfaction with benefits
- Better adherence to medication regimens can reduce long-term claims
This is also an opportunity to assess your broker relationship. With more choices in the pharmaceutical market, broker strategy matters more than ever. We break down the importance here:
Choosing the Right Employee Benefits Consulting Broker
Preparing Now for Tomorrow’s Landscape
It’s true that legislation like the Global Fairness in Drug Pricing Act still has several steps before becoming law, but waiting for final passage may leave employers scrambling to respond once changes are enacted.
While legislation isn’t final, there are meaningful steps employers can take now to prepare:
- Review your current pharmacy benefits and identify high-cost medications
- Engage with your broker about potential formulary shifts and carrier positioning
- Educate your HR and finance teams on the broader implications of reform
Staying proactive not only ensures compliance; it positions your organization to improve cost control and employee satisfaction when changes do come.
Looking Ahead
While the exact terms of drug price reform are still evolving, the direction is clear. Employers who anticipate the change and plan accordingly will be positioned to manage costs while enhancing their benefits offerings.
BSI is committed to helping you do both.