For many large employers, annual pharmacy costs can run into the hundreds of thousands — if not millions — of dollars. The natural reaction is to fix this by implementing cost-cutting measures such as rebates or moving a drug to a different tier. But these actions don’t address what is driving the costs: the conditions themselves.
According to the American Diabetes Association, an individual with diabetes faces healthcare costs 2.6 times higher than an employee without the condition. When the disease itself is the primary cost driver, adjusting a formulary tier is like repacking your suitcase for vacation — the clothes might fit better, but the bag still weighs the same.
