Exhibit 57b - Cal Yr 2025 City of Miami YTD as of Apr Stats by Ther Class _ Brand - Healthcare Spend and Trend - Pharmacy - Paid.xlsx

The document is a pharmacy statistical report for the City of Miami, detailing healthcare spend and trend data for pharmacy services from January 2024 to April 2025. The report provides a comprehensive analysis of prescription drug utilization across various therapeutic classes, including detailed breakdowns of generic and brand-name medications, script counts, ingredient costs, and employer/member paid amounts. Key metrics show an overall increase in pharmacy spending, with total ingredient cost per member per month rising 12.2% from $243.40 to $273.12, and total scripts per year increasing from 10.4 to 11.3.

The analysis reveals significant shifts in prescription patterns, with retail scripts increasing 10.4% and mail order scripts declining 8.6%. Generic rx utilization remained stable at around 93.8%, while specialty medications represented 52% of total employer-paid pharmacy expenses. The report breaks down prescription spending by tier, showing increases in preferred brand medications (48% growth in employer spending) and decreases in non-preferred brands. Notable therapeutic categories with significant changes include diabetic therapies, antineoplastics, and antivirals, with some categories experiencing substantial percentage increases in prescriptions and total spend. The data suggests a continued trend of rising healthcare costs and evolving prescription drug utilization patterns for the City of Miami's health benefits plan.