EPISODE · Apr 8, 2026 · 7 MIN
What Can We Do About High-Cost Specialty Medications?
from The Employer Benefits Playbook: Abbott Family Insurance Podcast · host Matthew Abbott
High cost specialty medications and GLP 1 drugs are blowing up pharmacy costs for small and midsize employers, but “just raise copays” is not a strategy.In this episode, Matthew Abbott breaks down a practical playbook for owners who feel like one or two prescriptions are hijacking their health plan. He explains what makes specialty meds so expensive, how PBM contracts and weak utilization management quietly drive costs, and what you can actually do about it as a trades or home service employer.You will hear how to tighten prior auth and step therapy without blocking appropriate care, why transparent pharmacy and site of care strategies matter, and how SIMRP style medical reimbursement and defined allowance models for GLP 1s can help you support the right employees without writing a blank check.If you are tired of being surprised by pharmacy at renewal, this conversation gives you a clear framework to turn specialty drugs from an uncontrollable expense into a managed part of your benefits strategy.#employeebenefits #pharmacycosts #specialtydrugs #GLP1 #smallbusiness #tradesbusiness #HVACbusiness #plumbingbusiness #benefitsstrategy #SIMRP
What this episode covers
High cost specialty medications and GLP 1 drugs are blowing up pharmacy costs for small and midsize employers, but “just raise copays” is not a strategy.In this episode, Matthew Abbott breaks down a practical playbook for owners who feel like one or two prescriptions are hijacking their health plan. He explains what makes specialty meds so expensive, how PBM contracts and weak utilization management quietly drive costs, and what you can actually do about it as a trades or home service employer.You will hear how to tighten prior auth and step therapy without blocking appropriate care, why transparent pharmacy and site of care strategies matter, and how SIMRP style medical reimbursement and defined allowance models for GLP 1s can help you support the right employees without writing a blank check.If you are tired of being surprised by pharmacy at renewal, this conversation gives you a clear framework to turn specialty drugs from an uncontrollable expense into a managed part of your benefits strategy.#employeebenefits #pharmacycosts #specialtydrugs #GLP1 #smallbusiness #tradesbusiness #HVACbusiness #plumbingbusiness #benefitsstrategy #SIMRP
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What Can We Do About High-Cost Specialty Medications?
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