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Tackling Specialty Drug Affordability: Empowering Self-Insured Employers to Regain Control Over Specialty Pharmacy Spend - NASH

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Prescription drug use and spend has been steadily increasing in the U.S. and around the world. According to an annual report from IQVIA, Americans spent $98 billion out of pocket on prescription drugs in 2024, a 25% cumulative increase over five years. The pipeline for specialty medications continues to be robust and growing despite higher costs and challenging regulatory requirements. Over the past decade, specialty medications have consistently represented a majority of new FDA drug approvals, rising from about two-thirds in the mid-2010s to approximately 80% by 2023–2024. While this trend underscores the pharmaceutical industry’s focus on complex, high-impact therapies for serious and rare conditions, it comes at a cost. In addition, utilization is expected to increase as more innovative treatments and advanced therapies such as cell and gene therapies (CGTs) become available, providers become more familiar with prescribing, and as many Americans get older, sicker and require more m

The specialty drug affordability issue Prescription drug use and spend has been steadily increasing in the U.S. and around the world. In fact, less than 5% of the U.S. population requires treatment with specialty drugs, yet they account for over 50% of net drug expenditure . According to an annual report from IQVIA, Americans spent $98 billion out-of-pocket on prescription drugs in 2024. This represents a 25% cumulative increase over five years . The pipeline for specialty drugs continues to be robust and growing despite higher costs and challenging regulatory requirements. Over the past decad

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