PBIRx's Approach To Managing Pharmacy Benefit Costs

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

In a time where the cost of prescription medications and pharmaceutical services continues to rise, there is a pressing need for them to be controlled. Did you know that records from 2014 suggest that for more than half of today's employers (77% to be exact), pharmacy benefit costs made up 16% or more of their total healthcare budgets? And although 16% might not seem like such a significant number to some right now, the reality is that the total percentage of healthcare costs dedicated to pharmacy benefits is only going to continue to grow as the cost of services continues to rise.

As one of Connecticut's top pharmacy benefit consulting firms, our goal is to provide entities with cost saving solutions that allow them to offer desired healthcare services at the lowest possible costs. To do so, we have created a proprietary tool known as our Specialty Drug Toolbox. The following is a brief look into each stage of this valuable tool that we use with each and every one of our clients:

1. Price: To determine whether or not you are paying a fair price for your pharmacy benefit plan, we consider the specific discounts and rebates that are available for generic drugs, biosimilars and limited distribution drugs. This way, we can figure out whether or not your plan offers medications and services at the right price.

2. Channel Management:  Once we are familiar with the discounts and rebates you are entitled to, the next thing we look at is the various channels that can offer them. Since rebates vary based on certain dispensing facilities, we narrow down which ones work best for your plan.

3. Clinical Review and Management: Next, we focus on your plan from a clinical perspective. That means we analyze how your plan is designed and compare it to clinical data to determine if any additional savings are available for positive healthcare outcomes.

4. Clinical and Pharmacoeconomic Outcomes: Finally, the last stage of our analysis includes studying how you are/should be managing patient disease states. This part of our approach ultimately looks at how both the patient and the disease will be cared for as the patient starts to use the services they are entitled to through your pharmacy benefit plan.

Now that you are more familiar with our approach and how we can work with you to control your pharmacy benefit costs, it's time to get started. For more information on our proprietary Specialty Drug Toolbox and how it can benefit you through our pharmacy benefit consulting and auditing services, contact us at (888) 797-2479 today.