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SJVIA hears 22% jump in pharmacy costs; board presses PBM performance on GLP‑1s and specialty drugs
Summary
Consultants for the San Joaquin Valley Insurance Authority reported a 22% year‑over‑year rise in total pharmacy plan costs driven by higher prescription counts and specialty drugs, prompting board members to ask for a formal comparison of PBM performance vs. RFP promises.
Consultants for the San Joaquin Valley Insurance Authority told the board that total pharmacy plan costs rose about 22% when comparing fourth quarter 2024 to fourth quarter 2023, and that increased prescription counts and specialty drugs were major drivers.
Eddie Barfield of Keenan, presenting the Keenan pharmacy utilization update, said “overall total plan costs in comparing the two periods has increased by about 22%” and highlighted growth in specialty drug fills and costs. He reported about a 12% increase in overall RX counts year over year and noted that specialty scripts and costs were a meaningful subset of that change.
The report identified GLP‑1 weight‑loss and diabetes drugs…
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