This session will explore pharmacy pricing trends for 2025 and 2026 that actuaries need to understand. It will cover historical trend data and future projections related to key industry developments, including expanding biosimilar utilization (particularly for Humira and Stelara), AMP CAP, the proliferation of GLP-1 diabetes and weight loss medications, and the impact of state and federal PBM laws.
Additionally, the session will examine the financial implications of emerging PBM pricing models on overall trends. Topics will include pass-through pricing, acquisition cost pricing (such as NADAC), and PMPM rate caps or guarantees.
- Future Actuaries
-
Education & Exams
Educational Pathways Associate of the Society of Actuaries (ASA) Fellow of the Society of Actuaries (FSA) Chartered Enterprise Risk Analyst (CERA) Micro-Credentials
- Professional Development
-
Research Institute
Aging & Retirement Artificial Intelligence Catastrophe and Climate COVID-19 Disability Diversity Equity & Inclusion Finance & Investment General Insurance Global Health Care Cost Trends Innovation & Technology Life & Annuities Long-Term Care Mortality & Longevity Predictive Analytics & Modeling Risk Management U.S. Population Valuation/IllustrationsSponsorships Proposal Requests Data Requests Calls for Papers Funding & Grants Competitions & Awards Academic & Student Research
- Communities
-
Tools & Resources
- About SOA
- Future Actuaries
-
Education & Exams
- Professional Development
-
Research Institute
-
Aging & Retirement Artificial Intelligence Catastrophe and Climate COVID-19 Disability Diversity Equity & Inclusion Finance & Investment General Insurance Global Health Care Cost Trends Innovation & Technology Life & Annuities Long-Term Care Mortality & Longevity Predictive Analytics & Modeling Risk Management U.S. Population Valuation/Illustrations
-
- Communities
-
Tools & Resources
-
About SOA
-
Topics in the News