Segal Increases Pharmacy Benefit Cost Trend for 2015

New York (4/15/15) —  Edward A. Kaplan, SVP and National Health Practice Leader for The Segal Group announced today that the firm’s pharmacy benefit cost trends forecast for 2015 were being raised to range from 13 to 15 percent. Segal’s initial pharmacy benefits cost trend forecast for 2015 had been 8.6 percent.

Dr. Ritu Malhotra, PharmD, VP and National Pharmacy Benefits Practice Leader commented, “This increase is driven by substantial expansion in the use of higher cost specialty medications being dispensed to patients as well as higher manufacturer price increases being passed along to consumers on often-prescribed brand and generic drugs. We are also seeing excessive prices as well as misuse in prescribing compound medications. Another factor is that there are limited cost offsets coming from new generic launces in the near term.”

Mr. Kaplan added, “As a result, pharmacy benefit costs per covered employee are approaching levels equal to what group health benefits plans spend on inpatient hospital claim expenses. We are looking at prescription drugs as potentially the biggest driver of cost increases for providing group medical coverage in the next few years. Employers and plan sponsors will need to examine new cost containment strategies requiring more financial and clinical data about treatment choices and coverage options in order to get drug cost trends to more sustainable levels.”

For more information or to speak with an expert, please contact Erin Burns, VP, at Segal: 212.251.5033 or

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The Segal Group ( is a private, employee-owned consulting firm headquartered in New York and with nearly 1,000 employees throughout the U.S. and Canada. Members of The Segal Group include: Segal Consulting, Sibson Consulting, Segal Select Insurance Services, Inc., and Segal Rogerscasey. In 2014, The Segal Group is celebrating the 75th anniversary of its founding by Martin E. Segal.