RX Costs

Reducing Claim Spend

RX Costs

Pharmacy costs are becoming a larger percentage of health plan spend. Even though patents expire, the cost of both generic and name brand drugs continue to rise. Pharmacy Benefit Managers (PBMs) are the “middle men” in this category of spend. Many PBM contracts are convoluted and not written in the best interest of the plan sponsor. Rebates belong to the plan sponsor, no one else. As a Fiduciary of plan assets, it is incumbent to purchase prescriptions at the most favorable price to the plan.

An assessment of your prescription costs with a forensic review of your contract will be very revealing. Our transparent approach provides pass-through pricing for all prescriptions and a contract that is written to protect the plan, not the pharmacy benefit manager. There is no “hidden agenda”. You receive 100% of all rebates immediately. You receive a pure pass-through of all costs. There is NO MARK UP. It is truly a cost-based platform. Employees would have minimum disruption, if any. The only source of revenue we receive is a modest monthly admin fee per employee.

pills
Client # of Lives Prior PBM Prior Spend
(PMPM)
Current Spend
(PMPM)
Change in
Spend
Percent
Savings
Annualized
Savings
Employer A 3,795 Caremark $63.35 $45.96 $17.39 27.5% $791,931
Employer B 4,409 Blue Cross $73.07 $64.86 $8.21 11.2% $434,371
Employer C 18,232 CIGNA $81.30 $73.40 $7.91 9.7% $1,730,424
Employer D 11,921 Walgreens $56.25 $43.90 $12.36 22.0% $1,767,507
Employer E 9,508 Anthem $41.71 $29.56 $12.15 29.1% $1,385,800