Client Challenge:
The rising cost of health care is a growing concern for employers. In 2020, a large school consortium with over 40,000 members experienced double digit trends driven by increased pharmacy costs.
Solution:
While there are aggressive formularies and utilization management programs in place to manage costs, edits and pre-authorizations cannot be applied to everything. Rx Concierge creates significant savings by identifying opportunities to further reduce prescription drug claims cost. By enrolling in Rx Concierge, this school consortium mitigated trend and saved millions of dollars over the course of four years.
Savings Example 1:
One group saved $487,381 from Cosentyx® conversions alone in the first four years of Rx Concierge.
Cosentyx® is a medication that may be used to treat plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and other inflammatory conditions. Cosentyx® is available as a 1-syringe pack and a 2-syringe pack, both cost the same.
The Rx Concierge team works to identify patients who are using Cosentyx® and ensure that they are receiving the most cost-effective package size available. For patients that are using 150mg monthly, it is more cost-effective to use the 2-syringe pack for a two-month supply due to the flat pricing of the medication.
This simple package size change led to significant savings for the client, saving them an average of $45,000 per conversion.