When Pharmacy Spend Saves Medical Spend: Rethinking Value in Health Benefits

When you make health and wellness benefits decisions, you make health care decisions. Health plan members will naturally seek out the highest quality care available to them at the lowest cost—wherever they see the greatest value or benefit. To support this, implementing evidence-based drug benefits and formularies that improve both availability and affordability of medications—such as semaglutide or liraglutide (GLP-1s or the biosimilars), along with pioglitazone or rosiglitazone (Thiazolidinediones)—can lead to significantly better outcomes and lower downstream costs. When taking a PROACTIVE CARE approach you find that strategically increasing pharmacy spend can reduce medical spend, ultimately lowering total cost of care. Supporting this, a recent study found that a combination of these two antidiabetic drug classes significantly reduced all-cause and cardiovascular mortality among patients with type 2 diabetes over a 10-year period (Li et al., 2025).

Li J, Hsu T, Lin H, et al. Combination of Glucagon-Like Peptide 1 Receptor Agonist and Thiazolidinedione for Mortality and Cardiovascular Outcomes in Patients With Type 2 Diabetes. JAMA Network Open, 8(3), e252577. https://doi.org/10.1001/jamanetworkopen.2025.2577