Implement a Responsible Pharmacy Benefit Plan to Combat Rising Costs

Clients and members alike are concerned about the rising costs of drug coverage. You see it every day. The traditional spreadsheet process used to compare PBM pricing offers is flawed because the model makes the inaccurate assumption that AWP and utilization will remain consistent with each vendor. No credit is given for the clinical management approach.

Our model focuses on clinical management and addresses price by helping members navigate to the most cost advantageous products and lowering client cost quickly and effectively.

And while most plans focus on discounts and rebates to combat rising costs, the real solution can be found in the savings that result from implementing appropriate clinical management.

Actionable Insight Reduces Drug Spend

We understand the value of a proactively managed pharmacy benefit plan. Our clinical care model focuses on identifying the issues and potential saving opportunities within member utilization. Through daily claims surveillance we examine factors that impact the overall performance of a plan including drug cost, appropriateness and necessity.

The EmpiRx Health Rx Efficiency Calculator identifies a client’s excess drug spend and inefficiencies on a therapeutic class by class basis. We compare drug utilization to best-in-class benchmarks in order to identify maximum savings opportunities. By identifying clinical savings opportunities clients often realize significant savings in overall drug spend.

Did you know that the uncontrollable specialty pipeline will increase utilization 2.5 times faster than traditional drugs? And with specialty drugs now accounting for 34% of pharmacy spend specialty drug cost containment is the highest priority for self-insured employers.

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