Recently, Healthcare Bluebook (Bluebook) launched Bluebook Rx, a pharmacy savings program aimed at drastically cutting prescription costs for employers, health plan sponsors and their enrolled members. And not a moment too soon.
Today, increases in prescription drug costs are outpacing inflation, forcing some large employers to devote as much as 30 percent of their total healthcare benefits spend to pharmacy … a serious issue compounded when you consider that one in four people can’t afford their prescription medications.
That’s not just a problem—It’s a moral dilemma when consumers forgo filling necessary prescriptions, or skimp on the prescribed dose, because of the cost.
As a longtime champion of healthcare consumerism, Bluebook co-founder and chief innovation officer Bill Kampine explained that a pharmacy savings solution is the natural extension of Bluebook’s purpose.
“Bluebook was founded to protect consumers and companies from over-priced, low-quality healthcare. Prescription medications, particularly specialty and brand-name drugs, have created an unsustainable cost situation for American consumers and businesses. Bluebook Rx identifies clinically comparable, lower-cost prescription medications and presents alternatives to patients for them to discuss with their doctor.”
How it works
Bluebook Rx conducts an objective analysis of a member’s claims data to identify over-priced prescriptions. Members who sign up for the pharmacy program receive monthly personalized savings reports that outline lower-cost options. Concierge support is available if needed, including personal guidance from Bluebook’s licensed pharmacy team. Through the program, members can potentially save thousands of dollars in out-of-pocket costs while companies can cut costs by millions by identifying waste and overspending.
A Fortune 500 company with 8,000 employees was looking for ways to radically cut pharmacy costs. An examination of its complex pharmacy benefits program revealed that a single drug had been costing the company more than half-a-million dollars a year. In addition, the analysis exposed extreme mail order price variances along with other spending anomalies that kept pharmacy expenses on the rise.
Savings opportunities were identified for the company and enrolled members through lower cost, clinically equivalent alternatives, ultimately saving each employee more than $500 annually while the company saved an average $1,312 per enrolled employee per year ($13.5 million total savings).
Equally important, the independent evaluation of pharmacy costs also allowed the company to pinpoint waste and negotiate better terms with its PBM (Pharmacy Benefits Manager).
In a recent feature article in BenefitsPRO, Kampine explained that employers are largely dependent on their PBMs to guide their pharmacy programs. Unfortunately, many PBMs are reluctant to share historical claims and rebate data, or they mask actual costs with rebate guarantees that make it difficult, if not impossible, to compare medications and eliminate waste in the program.
“As a result, employers struggle to actively manage their pharmacy benefit. In turn, employees struggle to navigate their formulary to understand which drugs are covered, the price and out-of-pocket costs, and whether they can or should be exploring an alternative medication.”
When a generic alternative medication can cost as much as 99 percent less than its brand-name counterpart (i.e., arthritis drug Otezla), it pays for companies and their benefits administrators to at least explore higher value alternatives that lower costs for everyone without compromising quality.
Just as Bluebook’s quality and cost navigation solution identifies high cost and low performing providers and guides consumers to high-value medical care, Bluebook Rx identifies clinically equivalent, lower cost medication options and guides members to more affordable care.
Perhaps the most powerful value delivered by Healthcare Bluebook is confidence through a level of visibility that empowers employers, health plan sponsors, and enrolled benefits members to compare options and make informed decisions on healthcare services and prescription medications.
Bluebook Rx is available to current and new Bluebook clients and their enrolled members, along with our complete suite of services that includes:
- Our industry-leading quality and cost navigation solution powered by Quantros Quality, the largest healthcare dataset in the U.S.
- Proven Engagement Solutions
- Bluebook Comply for employers and TPAs
- Bluebook Insights
- Bluebook CareConnect
Representatives are currently scheduling demos for Bluebook Rx. For more information or to set up a walk-through of the program, contact us today.