December 12 RxAdvocate December, 2025 — Newsletter
December Stories:
- GLP-1s and Specialty Drugs Drove Major Cost Pressures for Employer Health Plans in 2025
- Biosimilar Adoption Is Rising but Still Falling Short of Savings Potential
- Plan Ahead: Don’t Run Out of Medications This Holiday Season
- RxConnection Congratulates Our Newlywed Colleagues
GLP-1s and Specialty Drugs Drove Major Cost Pressures for Employer Health Plans in 2025
Health plans across the country reported another year of unexpectedly high medical spend and employers felt the impact. An analysis of major insurer financial filings demonstrated prescription drug spending grew faster than any other category, with many plans seeing 20%+ increases in 2025. The biggest driver: GLP-1 medications for weight loss and diabetes. Even with strict utilization management in place, insurers and employers saw unprecedented growth in GLP-1 use. Specialty drug spend rose across the board as well. Cancer and immunology drugs such as Keytruda, Opdivo, Skyrizi, and others experienced high growth. Higher drug spending can be valuable if it prevents costly hospitalizations and long-term complications. However, experts emphasize that many high-cost drugs are not priced in line with their clinical value, creating misalignment between spend and outcomes.
Biosimilar Adoption is Rising but Still Falling Short of Savings Potential
Ten years into the U.S. biosimilar market, uptake continues to improve but remains inconsistent and often too low to deliver the full savings employers and plans expected. While a few medication categories exceed 80% biosimilar market share, overall adoption averages only 40%. Three years post-launch, uptake ranges widely from 8% for insulin lispro to 82% for bevacizumab. Humira biosimilars have grown from 2% to 21% in 2024, driven by insurer and pharmacy contracting. Biosimilars launch at deep discounts and average 40% lower prices than brand biologics within three years. Their presence also reduces brand prices by about 23%; however, the current reimbursement model often pays providers more for using higher-priced brands, leaving biosimilars at a disadvantage. Biosimilars offer meaningful savings potential, but various incentives and reimbursement structures continue to limit their impact. Going into 2026, it’s imperative to understand how plans handle biosimilars and where plan design can steer members to lower-cost options as specialty spending grows.
Plan Ahead: Don’t Run Out of Medications This Holiday Season
The holidays often bring travel, busy schedules, and pharmacy closures, making it easier than expected to run out of prescription medications. Taking a few proactive steps can help you avoid unnecessary stress and stay healthy throughout the season. Check your medication supply early and request refills ahead of time, especially if your refill date falls near a holiday. If you’ll be traveling, ask your pharmacy or insurance provider about early refills or vacation overrides, and always carry medications in their original labeled containers. In case of an emergency, 24-hour pharmacies and urgent care centers may be able to provide short-term assistance. A little planning can go a long way in ensuring you have the medications you need—no matter where the holidays take you.
These materials are provided for informational and educational purposes. The website links provided are for convenience only. RxConnection is not responsible for the accuracy and validity of the content of those websites.
RxConnection Congratulates Our Newlywed Colleagues
The RxConnection team is delighted to celebrate a very special milestone for Emily Crowe and Emily King, who both recently tied the knot! Weddings mark the beginning of an exciting new chapter, and we couldn’t be happier for them as they embark on this journey filled with love, partnership, and shared adventures. It’s always a joy to celebrate meaningful moments like these within the RxConnection community, and we’re so proud to recognize two wonderful colleagues during such a happy time in their lives. Congratulations from all of us at RxConnection — we wish Emily Crowe and Emily King nothing but the very best as the they begin this beautiful next chapter.
Contact us
Orlando.Neal@rxconnectionllc.com