Abington Heights board hears consultants warn of rising health and pharmacy costs; GLP‑1 drugs singled out for savings options

The Abington Heights School Board on May 6 heard a detailed presentation from the district's benefits consultants about sharply rising health‑care and pharmacy costs and possible steps to rein them in.

Michael Cummings, a benefits consultant working with the district, told the board that the district’s self‑funded plan had experienced an approximate 30% net plan‑cost increase over four plan years — roughly 7.5% a year — moving from about $5.5 million to roughly $7.15 million annualized. "In particular, your pharmacy has gone up 88% over a four‑year period," Cummings said, citing the district’s claims data and stop‑loss reimbursements.

The consultants said the district changed its pharmacy benefit manager to SaveRx on Jan. 1, 2026. Cummings said three months of early data show reductions in per‑employee‑per‑month pharmacy cost and specific vendor programs that have returned manufacturer discounts and redirected low‑value medications. "Through three months, we're on track to hit that number," he said, referring to projected savings the RFP estimated.

A central focus of the presentation was GLP‑1 medications, the injectable drugs widely used for weight‑loss treatment and for some diabetes care. Consultants said GLP‑1s accounted for a disproportionate share of pharmacy spending: "GLP‑1 is your number‑one therapeutic class; 28% of your overall spend is on GLP‑1," Cummings said.

Cummings described a possible pilot with Revive Health, a telehealth vendor that the presenters said has direct‑to‑employer pricing arrangements with manufacturers. For a limited sample from Jan. 1 through March 10, the consultants presented a reprice analysis showing a net district spend on GLP‑1s of about $93,580 and a potential reprice cost near $39,000 under Revive's direct pricing. They projected that annualized GLP‑1 spend could be on pace for about $650,000 without intervention.

Board members asked how a Revive model would work in practice, whether Revive physicians would override local primary‑care decisions and whether the program could encourage higher utilization. Cummings said Revive’s approach includes active clinical engagement — physicians and coaches who interact with members — and a vendor fee (about $9 per employee per month) to administer the program. "We were concerned about clinical oversight and potential run‑on‑the‑store effects," a board member said; Cummings acknowledged those risks and said the district must negotiate guardrails with the vendor and the union.

Consultants also described how stop‑loss carriers can 'laser' large claimants — assigning a higher attachment point that raises the district’s risk and future premiums — and discussed consortium options that can spread risk but may produce large price increases for all members of a pool.

Dr. Schaeffer said administrators will meet with union representatives to present Revive and other alternatives and to explore a memorandum of understanding if the union agrees. "Tomorrow morning, we are all meeting with the union representatives to talk and present Revive," he said.

The presentation concluded with consultants offering to provide deeper analyses — including mail‑order versus retail use, the detailed SaveRx quarterly report and impact projections — so the board can weigh savings against continuity for current members.

Next steps: administration will return with additional data and report outcomes from the union meeting before any program changes are implemented.