Drug Cost Spiral Breaks Employer Benefit Plans

Rising drug costs and opaque PBM practices are forcing employers to treat prescription benefits as enterprise risk.

In 2026, U.S. employers are staring down another year of healthcare inflation with fewer tools to absorb it. Drugmakers plan to raise prices on at least 350 branded medications this year, with a median increase of about 4%. At the same time, the three largest pharmacy benefit managers now control nearly 80% of prescriptions filled in the United States, giving them enormous influence over pricing, access, and reimbursement. The result is that many employers are being asked to fund a benefits system they cannot fully see, audit, or predict. For corporate leadership, this is no longer just a benefits issue. It is a financial governance issue, a workforce issue, and increasingly, a business continuity issue.