Pharmacy savings calculator for self‑funded plans
Estimate how much your plan could save on prescription drugs in about a minute. Only member count is required. Nothing you enter is saved or sent.
[ Estimated savings opportunity ]
$616K – $1.52MPer year
2.6–6.4% of an estimated $23.7M in annual pharmacy spend · about $62–$152 per member per year
Directional estimate only. Actual results depend on your claims mix, PBM contract terms, and rebate arrangements.
Conservative assumptions, shown in full
No black box. These are the benchmarks and planning assumptions behind every number above.
Your spend
If you don't enter annual spend, we use $2,371 per member per year, the average commercial prescription spend in 2025 (UnitedHealth Group). We split spend into generics (about 12% of spend at a 90% generic rate, per the Association for Accessible Medicines), specialty (your input, default 50%), and other brands.
Brands with a generic available
1–3% of non-specialty brand spend, rising as your generic rate falls below 92%.
Lower-cost therapeutic alternatives
2–4% of non-specialty brand spend and 0.5–1% of specialty spend, plus 0.2–0.6% of total spend if GLP-1s are covered for weight management.
Generic pricing vs. actual cost
5–15% of generic spend for traditional PBM pricing, reduced for pass-through models.
PBM contract terms
0–2% of total spend depending on how long it's been since your last PBM review or re-bid, reduced for pass-through models.
This is a planning estimate, not an analysis. Savings percentages are StreamRX's conservative planning assumptions. A StreamRX analysis replaces them with your own claims data, pharmacist-reviewed.
Savings calculator, answered
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It's a directional range based on published industry benchmarks and conservative assumptions, not an analysis of your plan. Your actual opportunity depends on your claims mix, PBM contract terms, and rebate arrangements. A StreamRX analysis replaces these assumptions with your own claims data.
Average commercial prescription spend of about $2,371 per member per year (UnitedHealth Group, 2025), and generics making up about 90% of prescriptions but about 12% of drug spend (Association for Accessible Medicines). Savings percentages for each area are StreamRX's conservative planning assumptions.
No. Leave the defaults if you're not sure. Members covered is the only required input; adding your actual annual pharmacy spend makes the estimate more precise.
No. The calculator runs entirely in your browser. Nothing is sent to StreamRX unless you choose to request a free preview.
We review your plan size and design, with no claims data, and show where opportunities typically sit for a plan like yours. If it's worth a closer look, a full analysis takes about 4 to 6 weeks.
See your real number with a free preview
No claims data needed to start. Independent, pharmacist-reviewed, and paid only by you.