In 2024, groups enrolled in Rx Concierge saved over $17 million through more than 5,500 voluntary prescription conversions. Over 60% of those conversions fell within the following top five drug classes:
1. Mental Health/ADHD
- Savings: $5.8 Million
- Prevalence: One (1) in five (5) U.S. adults live with a mental illness
- Conditions: Bipolar disorder, schizophrenia, depression, anxiety, etc.
Rx Concierge Impact
Access to effective mental health medications that patients will accept and can afford leads to improved quality of life.
2. Diabetes
- Savings: $3.3 Million
- Prevalence: 14.7% of U.S. adults have diabetes, with an estimated 3% more unaware they have it
- Conditions: Type 1 and Type 2 diabetes
Rx Concierge Impact
Poorly managed diabetes can result in issues like blindness, kidney disease and amputation. Affordable diabetes medication regimens enhance adherence, contributing to better patient outcomes.
3. Multiple Sclerosis
- Savings: $1.3 Million
- Prevalence: Approximately one million people in the U.S. are living with multiple sclerosis
- Conditions: Multiple sclerosis
Rx Concierge Impact
Reducing patient cost burden for disease-modifying therapies helps patients manage their chronic condition optimally and reduces the overall financial impact multiple sclerosis has on patients.
4. Gastrointestinal
- Savings: $948,000
- Prevalence: 30% of the U.S. population lives with GERD, and one (1) in 552 Americans have ulcerative colitis
- Conditions: Gastroesophageal reflux disease (GERD), ulcerative colitis, etc.
Rx Concierge Impact
Affordable medication regimens help alleviate the financial burden on patients. Given the prevalence of GERD alone, reducing medication costs in this category has an impact on overall spend for most clients.
5. Ophthalmology
- Savings: $767,000
- Prevalence: Approximately 4.2 million U.S. adults have glaucoma, and 6.8% of the U.S. population has chronic dry eye
- Conditions: Glaucoma, chronic dry eye, etc.
Rx Concierge Impact
Minimizing side effects and enhancing affordability increases the likelihood of adherence to glaucoma therapy, which may decrease the chances of developing irreversible blindness from the conditions. Chronic dry eye is challenging to treat and burdensome for patients. Optimal use of topical treatments can lead to better disease outcomes and quality of life.
Clinical Value of Rx Concierge
Rx Concierge focuses on improving patient outcomes. By recommending tailored, affordable medication regimens, the program aims to ensure adherence and treatment success. Lowering costs for patients and payors is achieved through analyzing each patient’s regimen and suggesting affordable, effective alternatives. If patients cannot afford their medication, they are unlikely to take it regularly, negatively impacting treatment outcomes.
Addressing Inefficiencies and Unnecessary Spending
Common areas of inefficiencies include brand vs. generic utilization and inappropriate dosages. The active pharmaceutical pipeline introduces new brand-name products regularly, often with high price tags. Rx Concierge clinicians tailor recommendations to each patient’s coverage scenario, ensuring clinical effectiveness and affordability. Drug prices change rapidly and are impacted by many local and global factors, including supply-chain instability and novel regulations. This necessitates agile management to identify cost-outliers and adjust strategies in real time.
Factors Influencing Cost and Effectiveness of Therapies
Adherence, appropriate prescribing, and potential drug interactions play a significant role in the overall cost and effectiveness of therapies. Medications not taken due to cost or intolerable side effects lead to waste and inefficiency. Ensuring patients can afford their medication and take it regularly is crucial for treatment success and improving quality of life. If patients cannot afford their medication, they are unlikely to take it regularly, impacting treatment outcomes.
Recent Clinical Advancements
GLP-1 drugs have significantly impacted diabetes and weight loss therapy in the last two years. Originally designed for diabetes and obesity, these drugs are now being researched for other conditions like polycystic ovary syndrome (PCOS), cardiovascular disease, and kidney disease. With expanded eligibility, market uptake increases, necessitating oversight to ensure effective use without duplication or redundant medications. Rx Concierge clinicians monitor GLP-1 claims to ensure responsible spending and appropriate treatment.
Uncover Significant Savings with Rx Concierge
Rx Concierge by Candesa Pharmacy SolutionsSM works to uncover substantial savings across various drug classes, improving patient outcomes and reducing pharmacy costs without carve-outs, manufacturer programs, or claims adjudication changes. If you or your clients have a need for customizable strategies, especially within these drug categories, contact us today to learn how Rx Concierge can help save on pharmacy spend.
Individual savings may vary.