ProAct - PBM

Specialty drugs now represent more than 50% of total drug spending across pharmacy and medical benefits combined, despite being used by a small percentage of members. Many high-cost infused and provider-administered therapies are still billed through the medical benefit, where pricing transparency and utilization controls are often limited.   By strategically shifting appropriate specialty medications from the medical benefit to the pharmacy benefit, plan sponsors can gain greater visibility, access site-of-care optimization, leverage specialty pharmacy management programs, and take advantage of biosimilar opportunities. This can save plan sponsors upwards of 40% per claim.   At ProAct, we've seen how an integrated specialty strategy can help employers better manage trend while maintaining quality care and a positive member experience. Industry data shows specialty drugs now represent approximately 52% of total non-discounted drug spend, making proactive management more important than ever.   #SpecialtyPharmacy #ProAct #PBM #HealthcareCosts #SelfFundedPlans #Biosimilars #CostContainment #ProActPBM

For plan sponsors, diabetes care is becoming more complex – and more important than ever. 📈 In our latest podcast episode, Deborah Dempsey PharmD MBA, Chief Operating Officer, and Taylor Mishlanie PharmD MBA, Director of Clinical Operations, break down how integrated diabetes technology is changing the conversation around patient autonomy, clinical outcomes, and healthcare spend. 🎙️ They discuss: • The rise of tubeless pump technology. • Expanding indications for Type 2 and gestational diabetes. • What these shifts could mean for plan sponsors overall. 🎧 Listen to the episode to hear the full conversation: https://hubs.li/Q04snvSf0 #PharmacyBenefits #DiabetesCare #ProAct #PBM #Type2Diabetes #HealthcareInnovation #DiabetesTech #PlanSponsors #HealthcareSpend

The countdown is on – ProAct will be at the Texas Association of Benefit Administrators’ 2026 Fall Conference in less than one month! If you’re attending, be sure to connect with Deborah Dempsey PharmD MBA, Chief Operating Officer; Sarah Kittrell, Director of Account Management; and Suzi Huffman, MHA, Sales Director. 💡 Stop by to learn how ProAct helps organizations meet their pharmacy benefit goals with customized solutions and innovative ideas. #TABA2026 #TABAFallConference #TABAFall2026 #ProAct #PharmacyBenefits #PBM #SelfFunded #HealthcareNetworking

⏰ Just 2 weeks left until Part 2 of our Hot & Trending webinar series – Pipeline Insights: Looking Ahead. Hear from ProAct Chief Operating Officer, Deborah Dempsey PharmD MBA as she shares forward-looking insights on the trends shaping the future of pharmacy benefits. You won't want to miss out on this exclusive opportunity! Register today to secure your spot: https://hubs.li/Q04rGq980 #ProAct #PharmacyBenefits #DrugTrends #PBM #Webinar #IndustryLeader

What’s next for GLP-1 spend? 💰 The market may be stabilizing, but the financial pressure on plan sponsors is far from over. In our latest podcast episode, Deborah Dempsey PharmD MBA, Chief Operating Officer, and Taylor Mishlanie PharmD MBA, Director of Clinical Operations, unpack: • Why growth is starting to level off. • How expanded indications are sustaining demand. • Why spend relief remains limited despite manufacturer concessions. 🎧 Listen to the full episode for a closer look at the trends shaping the GLP-1 landscape: https://hubs.li/Q04rDgTG0 #PharmacyBenefits #GLP1 #PBM #ProAct #PlanSponsors #HealthcareCosts #HealthcareTrends #BenefitsStrategy #ClinicalOperations

A significant shift in the inflammatory disease market is underway as Pfizer's Xeljanz® (tofacitinib) now faces broad generic competition.   With discounts reaching 90%+ below brand pricing in some cases, generic tofacitinib presents a meaningful opportunity to reduce specialty drug spend while maintaining access to an established therapy for rheumatoid arthritis, ulcerative colitis, psoriatic arthritis, and other inflammatory conditions. While newer agents like Rinvoq® continue to dominate market share, the arrival of multiple generic manufacturers creates an opportunity to optimize costs where clinically appropriate. Not every trend in specialty pharmacy drives costs higher and this is a great example of where competition creates opportunities to deliver greater value for plan sponsors and members.   #PBM #SpecialtyPharmacy #Pfizer #tofacitinib #Xeljanz #DrugTrend #FormularyManagement #PharmacyBenefits #CostContainment #SelfFundedEmployers #RheumatoidArthritis #UlcerativeColitis #GenericDrugs

As a PBM, we closely monitor emerging therapies that have the potential to impact patient outcomes, healthcare costs, and benefit plan strategies. One area generating significant attention right now is the growing interest in peptide therapies. Last week, the FDA's Pharmacy Compounding Advisory Committee (PCAC) voted in support of adding several injectable peptides – including BPC-157, TB-500, KPV, MOTS-c, Epitalon, and Semax – to the 503A Bulk Drug Substances list, potentially allowing state-licensed compounding pharmacies to prepare these products in the future. Peptides are being promoted for a wide range of purposes, including weight management, recovery, wound healing, inflammation, longevity, and metabolic health. Social media, wellness clinics, and direct-to-consumer marketing have fueled tremendous awareness, driving demand well beyond traditional healthcare channels. Many of these compounds remain non-FDA approved, with limited human clinical data available to fully establish their safety and effectiveness. While the committee's recommendation may increase access, it does not represent an FDA determination that these therapies are safe or effective. For employers, plan sponsors, healthcare providers, and patients, this creates an important conversation regarding: - Balancing innovation with evidence-based medicine. - Protecting patient safety while supporting access to emerging therapies. - Monitoring increases in peptide utilization and the potential to impact healthcare costs and benefit plans. At ProAct, we believe innovation is critical to advancing healthcare. But innovation should always be accompanied by rigorous clinical evaluation, patient safety oversight, and thoughtful utilization management. The peptide market is evolving rapidly, and additional compounds are already scheduled for FDA advisory review in 2027. As this category continues to expand, healthcare stakeholders will need to navigate a complex landscape of patient demand, clinical evidence, regulatory developments, and cost management. The future of peptide therapy won't be defined by popularity – it will be defined by the evidence. #PBM #Healthcare #PharmacyBenefits #Peptides #ClinicalInnovation #EvidenceBasedMedicine #DrugTrends #HealthPlanManagement #PatientSafety #EmployerBenefits #SpecialtyPharmacy #HealthcareLeadership

Pharmacy spend is not only rising, it is shifting quickly. 🔄 Some of the biggest cost increases are coming from therapeutic classes many plan sponsors do not expect. Understanding where spend is moving is the first step toward a stronger benefits strategy. 👉 Download the full ProAct 2026 Drug Trend & Pipeline Reports and explore the latest data shaping pharmacy spend: https://lnkd.in/gpshCptM Interested in a closer look at what is shaping today’s PBM landscape? 🔍 Join us on Thursday, July 23, for our exclusive Drug Trend Insights webinar with Deborah Dempsey PharmD MBA, Chief Operating Officer. 👉 Register today to secure your spot! https://lnkd.in/gu--sKnj #PharmacyBenefits #EmployeeBenefits #PBM #PlanSponsors #DrugTrend #Biosimilars #PharmacySpend #BenefitsStrategy #GLP1 #Humira

Federal agencies have released the Affordable Care Act (ACA) and IRS indexed limits applicable to plan years beginning on or after January 1, 2027. Given the significant increase in the ACA Maximum Out-of-Pocket (MOOP) limits for 2027, employers should carefully evaluate whether increasing member cost-sharing aligns with their benefit strategy and employee affordability objectives. For clients offering HSA-qualified HDHPs, the IRS limits will continue to be the primary plan design constraint, as they remain substantially lower than the ACA maximums. This update is intended for informational purposes and should not be construed as legal or tax advice. Employers should consult their benefits advisor, legal counsel, or compliance partner regarding specific plan design decisions. #ACA #EmployeeBenefits #HumanResources #HDHP #HSA #CostSharing #PlanDesign #BenefitStrategy #HealthcareCosts #PBM

Are you a highly organized professional driven by excellence? 🚀 We are hiring a Project Coordinator to join our growing team and help expand ProAct’s impact in the PBM space through thoughtful coordination and innovation. 📍 Location: Remote (U.S.-based) 💼 Type: Full-Time 💰 Compensation: $24.00 - $26.00 per hour Check out the full job description and apply today: https://hubs.li/Q04pc_dC0 We offer a competitive salary and benefits package, including 401(k), stock ownership, medical, dental, vision, and prescription drug coverage with paid time off and holiday pay. #NowHiring #JobOpening #JobOpportunity #ProAct #PBM #ProjectCoordinator #ProjectManagement