With premiums increasing year after year, small employers are feeling the pressure. Discover how innovative pharmacy benefit solutions like Intercept Rx’s Rx Optimization Program can ease the burden and deliver real savings.
Table of contents
- The numbers tell the story #numbers-tell-the-story
- Why pharmacy spend is a major culprit #pharmacy-spend
- How small employers are responding #small-employers
- A modern alternative: Pharmacy Benefit Solutions #modern-alternative
- The power of the Rx Optimization Program #rx-optimization-program
- Why small businesses can’t wait for legislation to fix pharmacy benefit costs #small-businesses-legislation
- Conclusion: A smarter path forward #smarter-path
Introduction: A crisis brewing for small businesses
Health insurance is getting more expensive every year and small businesses are feeling it the most. A recent research¹ shared how rising premiums are forcing small employers to make tough choices. Some are cutting back on benefits. Others are raising deductibles or even thinking about dropping coverage entirely.
It’s not just a budget issue it’s a growth issue. Small businesses power almost half of the U.S. economy, but many don’t have the same buying power as big corporations. That means they often pay more to provide healthcare for their teams, putting them at a disadvantage when trying to hire, grow, or compete.
That’s where Intercept Rx comes in. As a Pharmacy Benefit Solutions provider, Intercept Rx helps small and mid-sized companies take control of one of the most expensive parts of healthcare: prescriptions. With our Rx Optimization Program, we help employers lower pharmacy costs, offer better benefits, and reduce the pressure they’re feeling from rising insurance prices.
The numbers tell the story
When it comes to rising health insurance costs, the data speaks for itself. Small businesses aren’t just feeling the pressure, they’re being squeezed from all sides.
According to the Kaiser Family Foundation’s 2024 Employer Health Benefits Survey², the average annual premium for employer-sponsored family health coverage reached $24,275, a 7% jump from the previous year. That’s thousands of extra dollars small employers are expected to cover, without necessarily seeing an increase in revenue.
And it’s not just the premiums. Rising deductibles, copays, and prescription drug costs are adding to the financial strain. Many small businesses are reaching a breaking point.
A separate report from the National Federation of Independent Business (NFIB)³ found that 98% of small businesses offering health coverage are concerned that the cost will soon be unsustainable. Even more alarming? 58% said they’re “very concerned.”
These aren’t just numbers. They represent business owners wondering how much longer they can keep offering coverage and employees worried about what happens if they can’t.
These figures paint a clear picture: something has to change. And for many small businesses, that change starts with smarter, more affordable pharmacy benefits.
Why pharmacy spend is a major culprit
When people think about rising healthcare costs, they often picture hospital bills or doctor visits. But one of the biggest cost drivers for employers today is something much smaller: prescription drugs.
Over the past few years, drug prices have grown faster than almost any other part of the healthcare system. This isn’t just a problem for individuals it’s hitting employers hard too, especially those with self-funded or level-funded plans.
One major reason? Traditional pharmacy benefit managers (PBMs) often make it hard to see where the money is really going. Many use complex contracts filled with hidden fees, unclear pricing, and rebate clawbacks which means they may keep a portion of the rebates from drug manufacturers instead of passing those savings on to employers and employees.
Even worse, many of the most expensive medications today, like GLP-1 drugs used for weight loss and diabetes, and specialty medications for chronic conditions, come with price tags of hundreds or even thousands of dollars per month. These types of drugs are becoming more common, and employers are footing the bill.
For small businesses, this adds up fast. Without full transparency or control over pharmacy spending, many companies are paying more than they should and getting less in return.
That’s why pharmacy costs have become such a critical part of the conversation around healthcare affordability. And it’s also why more employers are starting to look for smarter solutions that give them real insight and control.
How small businesses employers are responding
Faced with rising health insurance costs and unpredictable pharmacy expenses, small business owners are being forced to make tough choices. Many are looking for ways to cut spending but unfortunately, that often means reducing the quality of the benefits they offer.
One of the first strategies we see is increasing employee cost-sharing. That might mean raising deductibles, bumping up copays, or requiring employees to contribute more toward their monthly premiums. While this can temporarily ease financial pressure on the business, it often leads to dissatisfaction, lower employee retention, and difficulty attracting top talent.
Other employers are going a step further dropping coverage altogether or limiting eligibility to only certain employees. This is especially common in industries with tight margins, where the cost of providing health insurance can feel like a dealbreaker. But pulling back on benefits can harm employee morale and cause long-term damage to a company’s reputation.
There is, however, a growing number of small businesses that are taking a smarter route: switching to self-funded or level-funded health plans. These models give employers more control over their healthcare costs, especially when paired with transparent partners and data-driven strategies.
By shifting away from fully insured plans and toward more flexible funding models, small businesses can stop reacting to premium increases and start managing their costs more strategically.
This shift isn’t just about savings it’s about survival. And the right pharmacy benefits partner can make all the difference.
A modern alternative: Pharmacy Benefit Solutions
For years, small businesses have relied on traditional Pharmacy Benefit Managers (PBMs) to handle their prescription drug benefits. But with rising drug costs, complex contracts, and a lack of transparency, many employers are realizing that this old model just isn’t working anymore.
That’s why more companies are turning to a new kind of partner, Pharmacy Benefit Solutions providers like Intercept Rx.
Unlike traditional PBMs, Intercept Rx is built on a foundation of transparency, simplicity, and results. We believe employers deserve to know exactly what they’re paying for, how their money is being spent, and what kind of value their employees are actually getting.
So, what do we mean by “Pharmacy Benefit Solutions”?
- ✅ Transparency: Clear, honest pricing with no hidden fees or confusing rebate structures
- ✅ Technology: Real-time data and claims analysis to track spending and identify savings opportunities
- ✅ Advocacy: Support that helps employees navigate their medications, costs, and treatment options
- ✅ Guaranteed Savings: Our Rx Optimization Program is designed to cut pharmacy costs without reducing care
Intercept Rx isn’t just managing prescriptions, we’re solving pharmacy problems. And for small businesses that need every dollar to count, that can make a world of difference.
The power of the Rx Optimization Program
At the heart of Intercept Rx’s approach is a powerful solution designed specifically for today’s cost-conscious employers: the Rx Optimization Program. Built for self-funded and level-funded businesses, this program offers a smarter way to manage pharmacy benefits with real savings and no risk.
So, what makes it different?
$0 Copay options for employees
Employees get access to life-saving medications often for zero out-of-pocket cost. This improves health outcomes, boosts morale, and gives your benefits package a competitive edge.
Claims data that works for you
We dig into your pharmacy claims to uncover hidden inefficiencies, inflated costs, and unnecessary spending. Then we give you the tools to fix them without making your HR team do extra work.
Member advocacy that actually helps
From helping employees navigate prior authorizations to finding cost-effective sourcing alternatives, our member advocates are with them every step of the way. That means fewer headaches for employees and fewer questions for your team.
No upfront cost, no risk
The Rx Optimization Program is performance-based. There’s no upfront cost to get started you only pay if you see results. This makes it an easy “yes” for small businesses looking to save without taking on new financial risks.
“We didn’t think we had a problem with our pharmacy benefits until Intercept Rx showed us the numbers. In just a few months, we saved thousands and gave our employees better coverage.”
— Client Testimonial, Manufacturing Company (Alabama)
Whether you’re trying to stretch your budget, improve employee satisfaction, or both, the Rx Optimization Program is one of the fastest and most impactful ways to do it.
Why small businesses can’t wait for legislation to fix pharmacy benefit costs
When it comes to rising healthcare costs, time is not on a small business’s side. While many leaders are hoping that upcoming reforms will offer relief, waiting on legislation is not a strategy especially when premiums, drug costs, and employee expectations continue to rise.
The reality is that small businesses need practical solutions now. They can’t afford to gamble on what might happen in Washington next year. The good news? You don’t have to wait for new laws to start saving money.
That’s because pharmacy benefits are one of the most flexible and immediately optimizable parts of a health plan. Unlike medical claims, which are harder to predict and manage, pharmacy spending can be tracked, analyzed, and improved in real time. With the right partner, you can uncover savings within weeks, not years.
If you’re interested in how upcoming regulations could reshape your strategy, check out our article on 2025 pharmacy benefit reform laws and what they mean for employers.
But while reforms may help in the future, smart companies are acting today. Intercept Rx’s Rx Optimization Program gives you the tools to lower costs, improve benefits, and take back control starting right now.
Conclusion: A smarter path forward
Rising health insurance costs are putting serious pressure on small businesses across the country. Between premium hikes, expensive prescription drugs, and confusing benefit structures, many employers feel stuck trying to balance financial survival with doing right by their employees.
But it doesn’t have to be this way.
With the right tools and the right partner, you can turn your pharmacy benefits into a strategic advantage. Intercept Rx isn’t just another PBM we’re a Pharmacy Benefit Solutions provider with one goal: to help self-funded and level-funded businesses save money while delivering better care.
Through our Rx Optimization Program, we give you the technology and advocacy you need to take back control of your pharmacy spend with no upfront costs or risks.
Employers: Want to know how much you could be saving?
👉 Check out how the Rx Optimization Program can transform your business.
The path forward doesn’t have to be complicated. It just has to be smarter.
Key takeaways:
- Health insurance costs are rising fast, making it harder for small businesses to offer affordable coverage.
- Prescription drugs are one of the biggest cost drivers, especially with traditional PBM contracts lacking transparency.
- Many small businesses are cutting benefits or shifting to self-funded plans to regain control.
- Intercept Rx offers a Pharmacy Benefit Solution that prioritizes transparency, advocacy, and guaranteed savings.
- The Rx Optimization Program delivers $0 copay options, identifies waste through claims data, and includes member support with no upfront cost.
Now is the time to act before costs rise further. Employers don’t have to wait for legislation to start saving.
