Client

A mid-sized employer in the agriculture sector with about 400 employees and 680 lives on its benefit plan.

Challenge

Despite only experiencing modest increases in its medical benefit costs, the client was concerned about the rising cost of its pharmacy benefits and the risk associated with the potential impact of high-cost medications in the future.

They were in a “carve-out” relationship with their medical carrier’s preferred PBM partner. After discounts, the client’s annual Rx costs were $610,000.

Solution

Apex analyzed the client’s Rx claims and plan design using a unique sourcing model. Broad-based savings programs within the PBM were identified for the client. The team emphasized to the client alternatives to address current costs while incorporating PBM capabilities that would limit financial exposure due to future high-cost drugs.

Results

The savings found were substantial for the client. After discounts, rebates and fees the annual identified pharmacy savings were $110,156 for the client. Apex also discovered additional savings through clinical and specialty drugs of another $100,581. Those combined savings cut the client’s annual spend by 34%.