The Imperative of Affordable Prescription Medications: A Call to Action for Health Care Leaders

January 30, 2026

Affordable prescription medications aren’t just a “nice-to-have” — they're fundamental for improving patient outcomes and keeping our health care system from becoming financially unsustainable. When patients can’t afford the medications they rely on, they’re forced to skip doses, abandon treatment, or delay care altogether. This puts their health at risk and can lead to avoidable complications, hospitalizations, and long‑term costs that ripple across the entire system.

We’re acutely aware of the pressing issue of prescription drug costs and their impact on patient outcomes and overall health care expenditures. As health care leaders, we have a responsibility to take action because rising costs – especially drug costs – are straining families, overwhelming providers, and placing pressure on the system.

The Burden of Chronic Conditions

60% of Americans live with at least one chronic condition, resulting in significant health care utilization and costs. In fact, 90% of medical dollar spend goes toward care for people with chronic conditions, both physical and mental.¹

With many of these patients requiring medications to treat their conditions, pharmacy benefits are the most used benefits in health plans. It’s no surprise then that drug costs have been and continue to be on the rise. In fact, in the U.S., total pharmacy spend grew by 10% in 2024 and a similar increase is expected for 2025.²

When patients struggle to afford essential medications, this can lead to issues with medication adherence needed to treat their conditions, and ultimately increased hospitalizations, further straining the health care system. In addition, the affordability of specialty drugs, which make up a significant percentage of overall drug costs, continues to be a major concern as they can tack on more health care costs for both patients and the entire health care system. It's time we address this head-on.

The Need for Innovative Solutions

It’s clear that affordability in health care is a top concern for many Americans. And increasing access to affordable prescriptions is crucial for treating these conditions and improving patient outcomes. At Florida Blue, we're committed to making this a reality and are launching new programs to help tackle this issue.

Overview of Programs Launching on January 1, 2026

To help mitigate costs, we’ve introduced two new programs:³

• FlexAccess: This program connects members with prescription drug savings, reducing out-of-pocket costs at the pharmacy. By streamlining access to affordable medications, we aim to improve adherence and health outcomes.
• Advocate+ Pharmacy Match: This program automatically routes members' specialty prescriptions to the most affordable pharmacy option, eliminating the need for manual navigation and ensuring cost savings.

Recent Efforts

We've already made significant strides in reducing the costs of insulin medications — ensuring members receive the same high-quality drugs at a lower price. Many generic maintenance drugs for diabetes, asthma, depression, high blood pressure or high cholesterol are available as low as $0 for a three-month supply with home delivery service. Together, these efforts reflect our commitment to reduce financial barriers and help members manage their conditions without added strain.

Communicating with Providers

Successful implementation of affordability programs goes hand in hand with ensuring our providers are informed so they can support their patients. To this end, we regularly share provider bulletins detailing new initiatives. This proactive communication helps doctors and care teams understand program benefits, address member questions, and streamline access to affordable care.

By keeping providers up to date, we strengthen the doctor-patient relationship — empowering doctors to help their patients identify the best care and prescription options for their unique needs. Together, we’re making it easier for every member to access the medications they need to live healthier lives.

The Path Forward

Addressing health care affordability requires a multifaceted approach. We must:

• Emphasize value-based care: Focus on delivering high-quality, cost-effective care, including prescriptions, that prioritizes patient outcomes and ensuring no one is left behind in the pursuit of accessible care.
• Foster a culture of transparency: Encourage open communication about prescription costs and treatment options so patients can feel proactive and engaged with their health.
• Invest in innovative technologies: Leverage digital solutions to automate savings when possible. Also allow patients to compare drug costs and use home delivery services to save money and maximize convenience, which will enhance medication adherence.

Now’s the time

We urge fellow health care leaders to join us in driving down prescription drug costs through collaboration and innovation. By sharing best practices, leveraging data analytics responsibly, and advocating for policy changes that support better health for all, we can improve patient outcomes and reduce health care expenditures. Together, we can create a more sustainable and equitable health care system.

¹ The Growing Burden of Chronic Diseases. NIHCM. April 2025.