Reclaiming Affordability: A Sustainable Way to Deliver Prescription Benefits

The U.S. prescription drug affordability crisis has reached a breaking point. Net medicine spending is projected to climb 11.4% this year alone, driven by specialty drugs whose median launch prices have doubled in just four years. Meanwhile, families and employers are buckling under the weight of health insurance premiums that have soared 342% since 1999. This is not a sustainable path. The current system, built on opaque pricing and misaligned incentives, is failing the very people it’s meant to serve. It is time to champion a more transparent, equitable model that prioritizes patients over profits.

Breaking the Cycle of Hidden Drug Costs

For years, the true cost of prescription drugs has been deliberately obscured. Traditional pharmacy benefit managers (PBMs) have created a complex web of hidden markups, undisclosed rebates, and profit-driven structures. This model creates a system where intermediaries often make more money when drug prices are higher, perpetuating a cycle of escalating costs. The lack of transparency makes it nearly impossible for employers to forecast spending, control costs, or offer benefits that attract and retain the best employees. Americans represent less than 5% of the global population, yet shoulder the burden of 75% of the world’s pharmaceutical profits, paying over three times more for brand-name drugs than other high-income countries (HICs). This disparity is not an accident; it’s a feature of a broken system.

Where Pass-Through Pricing Actually Exists

True pass-through pricing rarely exists within the traditional U.S. drug supply chain. That is why global pharmaceutical sourcing matters: it is one of the only places where pass-through pricing actually exists today. Ethical global sourcing provides access to verifiable acquisition costs, free from hidden margins and rebate distortions. Rather than finding loopholes, this approach accesses the same high-quality medications sold worldwide—at prices that reflect their real, true value in the global marketplace.

By combining ethical global sourcing with a pass-through pricing model, employers gain predictable costs, transparent invoices, and the ability to see precisely where every dollar goes.

To achieve this, leaders must adopt a new mindset focused on three key strategies:

• Demand Absolute Transparency: Insist on pass-through pricing models where every dollar is accounted for, which means rejecting contracts with hidden fees or rebate schemes and partnering with organizations that provide clear, auditable data on drug acquisition costs.
• Leverage Global Supply Networks: Ethically sourcing medications from a global network allows for access to fair market prices, shielding plan sponsors from the inflated costs that dominate the U.S. market. This strategy is not about finding loopholes but about accessing the same high-quality medications at a price that reflects their true value.
• Reinvest Savings into Employee Benefits: True cost savings should benefit the people who matter most: the employees. By stabilizing prescription drug costs, employers can flatten premium increases and reverse the trend of shifting costs to employees by lowering deductibles, copays, and out-of-pocket costs.

The Path to Equitable Healthcare

The future of employer-sponsored healthcare depends on dismantling the profit-driven structures that have failed patients and employers for decades. Transparency is not merely a buzzword; it is the foundation of a fair system. By leveraging the pass-through models already available through ethical global sourcing, organizations can make the cost of medication predictable, fair, and aligned with true value.

This approach builds trust, strengthens long-term partnerships between employers and their benefit providers, and ultimately prioritizes human health over hidden profits. The transition to a transparent pass-through-based sourcing model is more than a strategic business decision; it’s a moral imperative that can lead to a more equitable and sustainable healthcare future for all Americans.