How can USI help our organization improve our pharmacy benefit plan’s cost-effectiveness and efficiency?
Standard carrier and pharmacy benefit manager (PBM) contract language is typically disadvantageous for employers. Even subtle differences in contract language can make a big difference in cost. Expert contract evaluation is a critical step toward gaining more control of your pharmacy plan costs. USI’s proprietary Contract Assessment Tool offers a simple and dynamic solution to begin identifying opportunities to reduce your pharmacy costs through expert contract evaluation and management.
USI’s proprietary pharmacy contract analysis tool identifies opportunities for a 20% - 30% reduction in pharmacy expenses, or 5% - 7.5% of total plan costs, compared to an unmanaged pharmacy contract.
We’ve estimated the financial impact for you. Feel free to update the assumptions.
- Total overall benefit plan savings of 5% to 7.5%
- Up to 100% of drug manufacturer rebates are paid to the employer
- Regular review of formulary options to reduce inclusion of drugs for the purpose of inflating PBM profit
- Price negotiation via contract review can be accomplished with no impact to plan members
Typically, contract negotiations with incumbent PBMs yield opportunities for savings of 10-15%.
Opportunities for an additional 10-15% reduction of costs are usually identified within the full procurement process.
It depends on your organization’s savings goals. USI’s proprietary tool assesses the financial impact of a change from your current pharmacy benefit contract’s terms and conditions to those of a top-quartile performing contract. In order to achieve maximum savings, a change in pharmacy provider may be required.
USI’s Pharmacy Contract Analysis is available to USI clients at no additional cost.
USI has a wide range of tools and solutions designed to impact overall costs.
One example: Additional savings can be made available by properly aligning incentives in your plan design, with limited impact to members.
I’d like to explore further how USI can help our organization improve our pharmacy benefit plan’s cost-effectiveness and efficiency.
To get started, USI will need just a few pieces of information from your organization, including your current pharmacy benefit contract and any recent pharmacy plan audits, if available.