As a team of benefits strategists, we work hard every day to make sure we’re exceeding client expectations and providing the most innovative and value-generating plan designs and advisory services.
Agriculture Employer Enjoys Annual Pharmacy Spend Reduction of About 34% After Claims Analyzed
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%.
Case Study
Download a printable version of this case study
More Case Studies
- August 31, 2023
Second Opinion Program Provides Support and Answers for Plan Members
A family employed by an Apex were seeking answers and resources as they navigated their child’s complex health challenges. Apex’s Second Opinion Program connect them with world-renowned experts and vital local support.
- July 27, 2023
County Creates Sustained Savings Through Switch from Fully Funded to RBR
A county government with 100 employees partnered with Apex to implement reference-based reimbursement. Over the next 6 years, they experienced sustained savings on both health care spend and PEPM costs.
- June 15, 2023
County Saves Millions with RBR and Changes to Pharmacy Benefit
A county government with over 450 employees partnered with Apex to implement reference-based reimbursement and saved millions over 7 years, decreasing their PEPM costs in the process.