Pharmacy Benefits Consulting

After reviewing the language of the pharmacy benefit management (PBM) contract that determined the terms and cost variables, savings opportunities were identified without changing any benefits to employees.

Everyone on planet Earth seems to have a different definition of what a Specialty Drug is and is not. Let’s break this term down, along with subsets of Specialty Drugs and their key terms.

Orphan drugs are drugs used to treat rare diseases. How rare? They appear in fewer than 200,000 persons in the United States. But even common drugs could be considered an orphan drug, which is important for health plan sponsors to …

Gene therapies are a new player in the world of pharmacy. So what do they bring to the table? While the treatments can be revolutionary toward curing diseases like blindess or even cancer, the costs of these therapies can be …

Specialty drugs are becoming more common for treatments. But what are they? And what can they do for a benefit plan? There’s not one true answer for those questions. However, Kinetiq Health Pharmacy Benefit Practice Leader Erin Albert, PharmD, discusses …

If your employees have ongoing prescriptions, here are some places for them to save money if they need to continue pharmacy prescriptions.

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 …

It might seem like Alphabet Soup, but knowing what NDC and J-Code means is an absolute must. Essentially, both are used to determine how your medical procedures or medications are billed to your health insurance. However, there are significant differences …

You’re probably getting ready to review your pharmacy benefits plan and how much you’re spending. How much you spend depends on your PBM contract, which can be anywhere from radically transparent to opaque. Consider these three tips to help lower …

It’s always important to ask questions to your PBM to make sure you’re getting the best benefit possible from the services. While we can come up with up to 10 different questions, we know there are three you absolutely should …

The perfect PBM does not exist, because no PBM might be perfection. However, that is unrealistic knowing that there are more than 20,000 prescription drugs on the market at any one time, more than 65,000 retail pharmacies out there in …

Does your organization take an active approach to saving money through its pharmacy benefits program? You’d be surprised at the potential cost saving opportunities that exist. At Apex, our Kinetiq Health Pharmacy Benefits Consulting Program just does that — save …