Prescription Drug Cost Containment

Prescription Costs

One of the biggest issues in healthcare right now is the rising cost of drugs, and in particular specialty drugs. This issue is contributing to escalating insurance premiums spawning double digit rate increases.

Organizations providing insurance to employees are feeling the pain the most. Economists agree healthcare costs are one of the biggest factors holding back economic recovery.  

Pricing for drugs runs the gamut across the global marketplace. For example, pricing for a drugs for hepatitis C might be 100,000 in the United States and this may be a better option based upon a transplant costing 250,000 because it is cheaper. The price tag your company is charged can also vary widely depending on where you receive your prescriptions.

How E.D. Bellis Solves This Problem

One of the services we provide is an extensive audit review process to analyze your Pharmacy Benefit Manager (PBM) to ensure the group is receiving maximum discounts and the Plan design is managed in a fiscally responsible manner.  While information to the above question may not be known, we can access the claim utilization to determine the effectiveness of the Plan.

Our process is different, because we are an independent auditor that represents multiple PBM vendors and, our analysis will provide you with a detailed summary of your current program and recommendations for any plan design changes and alternative discounts and rebates.

We are unique, in that, we do not represent one PBM vendor.

Items of review include:

Generic drug management
Counter-indicative prescriptions (incompatible drugs)
Duplicate dispensing
Age and gender compliance
Pharmacy utilization
Determine accuracy of average wholesale price
Administration and dispensing fee review

Sometimes we find an organization does not need improvement, however, more often than not we find a majority of programs can be more cost effective with appropriate revision. Our review includes a flat fee analysis, or if you engage one our recommended PBM administrators, your fee will be credited under our administration.

Specialty Drugs

Listen to this interview from our weekly talk radio show America’s Healthcare Challenge. This segment that explains why drug pricing is so complex and how we as a nation can solve this problem.

For more on how we solve this problem, download our questionnaire and give us a call at 844-626-7202.