Why 2026 Demands a Smarter Pharmacy Strategy

Viewpoints from Mike Medel, PharmD, MBA

Pharmacy benefits are no longer just a line item – they’re a strategic challenge that’s reshaping budgets and demanding more innovative solutions. Between the rising costs of specialty drugs, the growing influence of GLP-1s, opaque pricing models, the complexity of PBM contracts, and mounting legislation, pharmacy is quickly becoming one of the most unpredictable – and expensive – lines in your benefits budget.

At EPIC, we hear the same questions from our clients across industries: How do we better manage pharmacy costs and stay ahead of long-term trends? How do we ensure transparency in pricing? And how do we make sure our pharmacy strategy supports – not strains – our broader benefits goals?

Whether you manage a fully insured or self-funded plan, we have actionable insights to help you optimize your pharmacy strategy.

In our upcoming strategy session, you’ll hear directly from pharmacy consultants like me at EPIC Pharmacy Solutions, powered by PSG, who work with plan sponsors like you every day to solve real-world challenges. We’ll break down what’s driving costs, where savings might be hiding, and how to build a benefit plan that’s both sustainable and smart.

The Cost-Control Imperative

Pharmacy spend is one of the fastest-growing components of employer-sponsored health plans. High-impact therapies like GLP-1s, biosimilars, and emerging cell and gene treatments are reshaping budgets. Without a proactive strategy, these innovations can quickly become financial liabilities.

Forward-thinking organizations are shifting from reactive cost management to strategic optimization. That means re-evaluating traditional PBM contracts, exploring alternative pricing models, and strengthening audit capabilities to uncover hidden value. The devil is in the details.

Transparency Is the New Currency

Opaque pricing has long been a challenge in pharmacy benefits. But new models are emerging that may offer greater clarity and control. Employers are increasingly demanding visibility into how dollars are spent, how rebates are structured, and where opportunities for savings exist.

Audit Smarter, Not Harder

Audits are often underutilized, but they’re one of the most powerful tools employers have to ensure value, accountability, and help you meet plan fiduciary goals. A well-executed audit should uncover discrepancies, validate contract compliance, and identify missed savings opportunities.

The key is knowing what to look for. Strong audit rights, paired with strategic execution, can reveal hidden costs and inefficiencies that might otherwise go unnoticed. In today’s environment, audits aren’t just a safeguard – they’re a strategic advantage.

Clinical Strategy Matters More Than Ever

It’s not enough to know what drugs are driving spend – you need to understand why. Clinical oversight is critical to managing utilization, ensuring appropriate prescribing, and anticipating the impact of new therapies. A strong clinical strategy helps align pharmacy benefits with broader health outcomes and cost containment goals.

Ready to Transform Your Strategy?

Reserve your seat today and take the first step toward a smarter, stronger, and more cost-effective pharmacy benefit plan for 2026. This session is built for decision-makers like you – focused, practical, and packed with takeaways you can put to work right away.

Join our live virtual event on Thursday, August 21, at 1:00 p.m. ET. Whether you’re building your 2026 pharmacy strategy from scratch or refining what’s already in motion, this session can give you the insights you need to move forward with confidence.

EPIC offers this material for general information only. EPIC does not intend this material to be, nor may any person receiving this information construe or rely on this material as, tax or legal advice. The matters addressed in this document and any related discussions or correspondence should be reviewed and discussed with legal counsel prior to acting or relying on these materials.

Get in Touch with Panelist

Mike Medel, PharmD, MBA, Senior Vice President and Practice Lead, Plan Sponsors | EPIC Pharmacy Solutions, powered by PSG | Contact Mike via phone or email.