Prescription Claim Avoidance
Specialty Statistics from PBMI: "Patients who use specialty medications made up about 4.9% of commercially insured member populations in 2017, up from 3.9% in 2015. This growth in specialty drug use prevalence, along with price increases, is part of the reason that specialty drug spend is now 50% of total drug spend and is forecasted to reach 60% by 2021."
Our vendors offer access to programs that can obtain hundreds of Specialty (High Cost) medications from the same manufacturers that they are coming from today at half the cost.
An example of recent savings for just one of our clients: By just working with 16 patients out of a 2000 life self-funded group, our program saved this client $363,431 in just 4 months.
Patients do have to qualify, but it’s not what you think. There are very popular Specialty medications that will allow a patient, covered under a self-funded Plan (PBM) to obtain the same medication directly from the manufacturer at half the current cost of the Plan payment AND the patient experiences no copay or out of pocket.
It does not cost you anything to obtain a quote, If you provide just a few de-identified fields from you or your client’s monthly drug claim file.
The following fields (per script, excel format) are required to obtain a quote:
DISCLAIMER: In the event that a file containing PPI or PHI is submitted through this site. The file will be deleted and the sender notified.