Rx Costs Up 8.6%, Anthem Getting Sued, & Doulas Improve Outcomes

Hey all,

I’m thrilled we’re finally getting some much-needed rain here in the NY metro area. Today’s rundown is essentially a masterclass in things that are absolutely not surprising. Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroCard)

U.S. Survey on Health and Benefits Strategies for 2025 (Mercer)

The survey emphasizes the challenges posed by high-cost claimants and specialty pharmacy expenses, with prescription drug costs increasing by 8.6% in 2023, driven by the rising use of GLP-1 drugs and high-cost gene and cellular therapies. Transparency in PBM pricing is a priority, with 24% of employers willing to pay more for clearer cost structures. Additionally, 14% of employers plan to share pharmaceutical rebates with members at the point of sale by 2025. These measures reflect a growing focus on controlling specialty drug costs while ensuring access to essential therapies. Full Article

Owens & Minor Sues Anthem Over Health Plan Mismanagement (PlanSponsor)

Owens & Minor is suing Anthem for allegedly bungling its self-funded employee health plan, citing excessive fees, claim mishandling, and a refusal to share critical cost data—behavior that is, let’s be honest, less an aberration and more a defining characteristic of big third-party administrators. The lawsuit, which accuses Anthem of breaching fiduciary duties under ERISA, highlights the ongoing “surprise” employers face when expecting transparency from TPAs. Full Article 

Doulas Linked to Lower C-Section Rates (EmployerCoverage)

A recent study highlighted by EmployerCoverage reveals that the presence of doulas during childbirth is associated with a reduced likelihood of cesarean sections. This aligns with broader efforts by employers to address maternal health disparities, particularly among Black women, who face disproportionately high maternal mortality rates. By supporting non-clinical, continuous care through doula programs, employers can enhance health outcomes while addressing health equity concerns in their workforce. Full Article