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Reducing the cost of prescriptions

We’re helping members pay less for prescriptions by partnering with pharmacies and physicians and regularly updating our coverage policies to ensure members get the right drug at the right price. That’s Active Affordability.

Finding ways to make prescriptions more affordable

Working to reduce the cost of
specialty drugs

  • Specialty drugs, which treat rare and complex conditions, account for nearly 50% of drug spending in the U.S.1
  • We’re working with hospitals to source specialty drugs from more affordable specialty pharmacies. Studies show that hospitals on average charge double the price for the same drugs sold by specialty pharmacies.2
  • Administering specialty drugs outside hospital settings may help improve care and reduce costs. The cost of specialty drugs and their administration may be significantly lower if administered through physician offices and patients’ homes.1

Developing innovative ways
to lower drug costs

  • We're helping lower prescription drug costs by making biosimilar drug recommendations and offering coverage of low-cost generic drugs.
  • We evaluate each brand-name biologic and its biosimilar one-by-one and make a coverage decision based on the lowest cost product and other relevant factors. This approach may help us deliver lower drug costs for our members.
  • We’re also looking across the system to identify outlier pricing and high costs. For example, we negotiate with prescription drug manufacturers to help make high-cost drugs more affordable.

Securing discounts for prescriptions

  • Point-of-sale discounts are a way to pass on drug manufacturer rebates to our members. That may mean lower costs for member prescriptions.
  • Since 2019, point-of-sale drug discounts have helped members save $130 on average per prescription3 and $189 annually on average in out-of-pocket costs.1 In 2020, we led the industry by expanding our point-of-sale drug discount programs to all new employer-sponsored plans.1  

Addressing the rising price of prescriptions

Americans are often unable to fill and take their prescriptions as prescribed due to the high cost. We are actively working to help reduce prescription drug costs.

Struggling to pay for prescriptions

More than half of all adults take at least one prescription drug, but 3 in 10 adults don’t take their prescriptions as prescribed because of the cost.4

Finding the right setting to administer drugs

Administering specialty drugs in alternate settings may save an estimated $16,000 to $37,000 per patient per year (individual results may vary).1

How America’s drug price estimates compare

On average, Americans spend more than $1,200 per
year on prescription drugs, which is among the highest rates in the world.1

The role of generic alternatives

Beta-blocker brand medications, which are used to treat cardiovascular conditions, can be 10 to 20 times more expensive than generic alternatives.5