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.
Rebates and PBM Contract Review Net 55% in Rx Cost Savings
A mid-sized company with diverse holdings in the food and entertainment sector with about 400 employees
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.
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.
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.
More Case Studies
- September 13, 2021
It was determined that the client was due a refund. The Township not only saved money, but also saw an improved return on their investment for the clinic. The savings understandably left the client pleased knowing it was spending less …
- August 31, 2021
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 …
- August 31, 2021
By identifying the employee’s medical and behavioral issues and specific needs, the Kinetiq Health team was able to establish individualized care paths to manage chronic conditions. The employee was steered to an appropriate place of service for ongoing monitoring. While …