GLP-1s and specialty drugs are driving a major surge in employer healthcare costs, and many CFOs, CEOs, and HR leaders feel stuck between absorbing higher pharmacy spend or cutting benefits. In this episode of Blueprints for Better Benefits, Rodney Mattos breaks down why GLP-1 medications, specialty pharmacy costs, and rising prescription drug spend are becoming some of the biggest drivers of health plan inflation in 2026.
You’ll learn how a properly structured self-funded plan can give employers better pharmacy cost visibility, more control over specialty drug spending, and practical tools like prior authorization, step therapy, and biosimilars to manage costs without harming employee care. The conversation also explores how captive health plans and smarter health plan strategy can help businesses control rising healthcare costs while still protecting benefits, improving retention, and supporting long-term financial stability.
If you are looking for insights on GLP-1 costs, specialty drugs, self-funded health plans, employee benefits strategy, and how to manage healthcare costs without cutting benefits, this episode is for you.
In This Episode, We Cover
- Why GLP-1s and specialty drugs are driving pharmacy trend increases in 2026
- How rising prescription drug spend affects employers, budgets, and employee benefits strategy
- The biggest myth employers believe about GLP-1 costs and specialty pharmacy costs
- How a self-funded plan creates visibility into actual pharmacy spend and medical bills
- How prior authorization, step therapy, and biosimilars can help control specialty drug spending
- Why captive health plans can give employers more leverage and flexibility than fully insured plans
- How employers can manage healthcare costs without cutting benefits or harming employee care
- Real-world examples of companies using self-funded plans to reduce pharmacy costs and improve budget stability
Explore More
- Explore our insurance agency, Triforta: https://www.triforta.com/
- Learn more about our software for insurance agencies, Apeironix: https://apeironix.com
- Visit the full podcast website, The Rodney Mattos Show: https://rodneymattos.com/
Connect with Rodney
Email: rmattos@triforta.com
LinkedIn: https://www.linkedin.com/in/rodneymattos