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Showing posts from November, 2017

What's My "WHY" for Pharmacy Benefit Management Solutions

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When you meet someone and start talking to them about the business that they're in, they usually can tell you pretty quickly what they do. But the "what" of their chosen career path doesn't really give a lot of information as to why you'd want to work with them if you ever needed their product or services in the future. It's the "WHY" that really gives us the warm and fuzzies. And for many, that's a tough question to answer! Unless your "why" is truly the reason for doing what you do, like mine is. So what's my "WHY?"

Doing What's Right for Employers Prescription drug costs are at an all time high. Unfortunately for small or self-funded businesses, this could mean you're shelling out a lot more for your coverage costs than those larger companies. Employers, you could be paying more for your prescription drug program than you ever expected, and getting less and less for your money. You deserve the best for your inve…

A Focus on Diabetes Nonadherence & Cost

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According to the Center for Disease Control and Prevention, diabetes is the seventh leading cause of death in the United States. Studies have shown that diabetes affects patients, employers, and society not only by reducing employment but also by contributing to work loss and health-related work limitations for those who remain employed. It's essential to find a way to ensure that your employees that are in need of diabetes medications are able to get them without struggle.


Overcoming Poor Adherence
Unfortunately, although these medications are essential for the health and wellbeing of patients, medication nonadherence is still an issue for several reasons. Not only is taking diabetes medications burdensome or difficult for patients, but it's also very costly and patients simply do not have access to their medications. To try to save money on their medications, patients may avoid filling their prescriptions or may begin cutting back on their dosages against their doctor's r…

The Complexities of How Pharmacy Benefits Work

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The prescription drug industry has changed dramatically. It can be difficult to navigate between continual regulatory changes, new therapies and skyrocketing drug costs to ensure the best decisions are being made for your employees, while preserving cost. With the increasing costs of pharmaceuticals, it's essential for employers to have a good understanding of the complexity of how pharmacy benefits work

Reviewing Your Options Much like anything business owners must consider putting money into, employers want to "kick the tires" to see if they're getting the best deal on their prescription drug spending before committing to a contract. A common issue that employers run into though, is that they don't know how to do this when it comes to pharmacy benefits, or who to depend on. And unfortunately, just plopping proposed discounts on an excel spreadsheet are meaningless due to financial optics that can make the deal look better than it really is. Getting a professi…

Understanding Patient Non-Adherence and How to Prevent it from Affecting Your Rx Plan Costs

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There are many different reasons why patients don't take their medications as prescribed. And unfortunately, prescription non-adherence affects the overall cost of health care. While it may be tempting for employers to cut costs by raising deductibles, out of pocket maximums and copays, there are other solutions to help curb the cost. We want to help employers save money while allowing them to remain empathetic toward employees and the need to continue providing prescription drug benefits with affordable copays. So, let's first take a look at the reasons behind patient non-adherence, then we'll address ways to control it:


Reasons for non-adherence:

Cost of Medications
The cost of many medications, especially for chronic illnesses that require specialty drug treatment, can be quite expensive. If these prescriptions aren't fully covered by the patient's prescription benefit plan, this could cause some financial duress for the patient and make them feel as though they m…

Save Money by Taking the Mystery Out of Your Pharmacy Benefits Plan

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Prescription medication spending continues to rise, and for self-funded employers these cost increases can really take a toll on finances. Obviously, pharmacy isn't YOUR business specialty, nor should it be. The rising costs and the factors that drive them tend to be a mystery for employers like yourself. Sadly, most employers just continue to pay as the bill increases because they don't know what they can do about it.


The first step in managing cost is to understand what's driving the ever-increasing prices, and then from there you can determine the best solution for managing the costs and care of your employees. So let's start by addressing the problem.

The Problem:
High prices of pharmacy benefits plans are driven by:

1. High cost of specialty drugs
Specialty drugs are used by 1-3% of the US population, but account for around 35% of the total drug costs. The projected specialty drug/biotech trend rate for 2017 is an exceptionally high 18.7%.

2. Lack of transparency
Ma…