We use cookies to provide services and improve browsing experience on this website. See our Cookie Policy for more information. By continuing to browse this website, you agree to the automatic use of cookies. We’re sorry we are currently unable to provide real delicious cookies to you and your friends.
Client
A mid-sized company with diverse holdings in the food and entertainment sector with about 400 employees
Challenge
The employer was content with the pace at which overall benefit costs were rising over the years but wanted to tackle the disproportionately high rise of pharmacy benefit costs. The client sought ideas to reduce the costs while maintaining the overall quality of benefits enjoyed by its employees. The client was in a “carve-in” PBM through a national carrier and its annual Rx costs were $1,055,385 after discounts.
Solution
The Apex team identified hidden sources of revenue the PBM embedded in the client’s contract. After reviewing the language of the PBM that determined the contract structure and pricing, the client was able to find savings without changing any benefits to its employees.
Results
After discounts, rebates and fees, the client enjoyed annual savings of $405,311 from its Rx spend. Apex also uncovered additional savings through clinical, utilization and specialty drugs of another $117,874. That meant more than $580k in savings. Those savings totaled 55% of the costs from the prior year, a drastic reduction in spend.
Case Study
Download a printable version of this case study
Download Case StudyMore Case Studies
- August 31, 2023
Second Opinion Program Provides Support and Answers for Plan Members
A family employed by an Apex client was seeking answers and resources as they navigated their child’s complex health challenges. Apex’s Second Opinion Program connected 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.