Rising prescription drug (Rx) costs are one of the nation's fast-growing components of healthcare, which means employers, and their advisors, must slay this beast before they can bend the cost curve in any meaningful way.
With the holidays upon us we wanted to celebrate, and give thanks, to some of the innovation in this vertical that is allowing employers to make immediate impact. This month we will discuss the games that are played in the prescription drug (Rx) space by pharmacy benefit managers (PBM).
Their No. 1 tactic is called spread pricing. It occurs when PBMs keep a portion of the amount health plans pay them instead of passing full payments on to pharmacies. The resulting shell game eliminates any transparency, hiding from employers and their advisors the true cost of prescription drugs.
How do you control something you can’t see? Ask your PBM partners if they allow spread pricing? Want to learn more? Watch this video.
Milliman White Paper on Rebates
Webinar: Celebrate Innovations in Rx
Join several leading industry experts on December 5 for a webinar that will help you:
Understand the impacts of spread pricing
Realize that MOST rebates DO NOT equal the LOWEST cost
Learn strategies that can impact your pharmacy spend by 30%–50% immediately. All while saving costs for members
Don’t miss your chance to CELEBRATE. RSVP NOW!
Meet Our “Rx-perts”
Chief Operating Officer, 44North
Sarah has 12 years of experience in employee benefits, third-party administration and high-cost pharmacy benefit management. Her firm, one of the largest benefit consultancies in Michigan, has saved clients more $12 million in 2019 on their pharmacy spend through its ARORx service.
Managing Partner, Local Script, LLC
Jim strongly believes that leveraging the values and services that local independent pharmacies bring to their communities will help employers bring better access and quality of care to employees while driving down their cost. He’s also co-founder and partner of Dynamic Benefit Solutions, LLC, a NextGeneration benefits firm with more than 400 corporate clients.
Chief Sales Officer, WellDyne
Rich identifies and executes sales strategy for teams representing all market segments, aligning relationships with clients and their members. Prior to joining WellDyne, he oversaw new business efforts at OptumRx, and served as VP of sales and marketing at Innoviant, a startup pharmacy benefit administrator.
President and CEO, Right Rx, LLC
Renzo has more than 25 years of experience in the healthcare industry, including roles in drug development, manufacturing, marketing, dispensing and care delivery, as well as pharmacy benefit risk management. He also has served in numerous management capacities at well-known companies including Ernest & Young, Abbot Laboratories, and WellPoint/Anthem.
CEO & Founder, Next Impact
Morales is a true consultant, and highly sought-after speaker, in the human capital and employee benefits arena and currently serves as CEO of Next Impact, an employee benefits and human resource marketing and consulting company. Prior to becoming an entrepreneur, Lester served nearly three years as Executive Vice-President and Chief Growth Officer for Willis’ Human Capital Practice, one of the largest insurance brokerages in the world.