Exhibit 68 - Cal Yr 2024 City of Miami RX Stats by Ther Class _ Brand Healthcare Spend and Trend.xlsx

This file is a pharmacy statistics and healthcare spend report for the City of Miami's employee health benefits plan covering calendar year 2024, with comparative data from the previous year. The document provides a comprehensive breakdown of prescription drug utilization across multiple therapeutic classes, including detailed metrics on script counts, ingredient costs, employer and member payments, and trends across generic, preferred brand, and non-preferred brand medications. The analysis covers 46,076 total prescriptions across various medical categories, with a total employer paid plan amount of $12,938,556 for the current year, representing a 24.7% increase from the previous year's $10,299,036.

Key financial and utilization highlights include an average of 4,422 members, a 23.8% increase in ingredient cost per member per month (from $203.57 to $251.99), and a 4.9% increase in scripts per year (from 9.9 to 10.4). The generic prescription utilization rate remains high at 93.1%, with specialty medications comprising 53.1% of total employer-paid pharmacy expenses. The most significant prescription categories by spend include diabetic therapies, antineoplastic medications, and miscellaneous immunomodulator agents. The report indicates a shift towards more expensive specialty and brand-name medications, with average costs for non-preferred scripts increasing by 27.8% to $1,980.68.