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Pharmacy plan savings estimator

Are you interested in learning what you could save on pharmacy expenses? Use our savings calculator to discover how much you could lower your current pharmacy plan spend with Marsh McLennan Agency’s Rx Solutions.

Before you start

Selecting a coverage plan that delivers your employees the necessary prescription drugs at a price that won’t strain your budget or your employees’ wallets doesn’t have to be hard. Our Rx Solutions specialists' approach to pharmacy management helps employers create plans that satisfy their budget and their employees' prescription needs.

Our data-driven and people-focused solutions help you navigate the pharmacy benefits space. We help you identify creative solutions that maximize savings and allow you to take care of your employees.

Before you launch the savings calculator, gather these key pieces of information so we can accurately estimate your savings:

1. Your approximate annual spend on pharmacy benefits.

2. The total number of people on your plan. If there are over 1,000 individuals currently using your plan, we’ll need to ask a few extra questions.

3. General information about your current pharmacy benefit manager (PBM).

By answering just a few questions, you’ll have your savings estimate in minutes.

 

Frequently asked questions

According to proprietary Marsh McLennan Agency client data, pharmacy claims account for 25.6% of every dollar spent on health care claims. This data shows the importance of understanding the impacts on the costs of pharmaceutical benefits  for employers. Newer, more expensive drugs that treat complex conditions, price increases on existing medications, and increased utilization of certain medications are all driving factors of pharmacy prices. In the absence of demographic information, an employer’s industry can be an effective predictor of health care expenses, as different industries’ utilization and cost trends reflect that industry’s demographics and benefit designs.

Pharmaceutical companies use rebates to incent PBMs to include their drugs on their formularies, also known as preferred drug lists. PBMs then offer part of these rebates to employers to offset a portion of their pharmacy benefits costs. PBMs share these rebates with employers through administrative credit or minimum rebate guarantees. The language in the PBM contract on which drugs receive rebates is very complex and can require specific expertise in pharmacy contract language to navigate the protections and rebate structures available to employers. In addition, while rebates help employers offset some of their pharmacy costs, they can also result in formularies including unnecessary expensive drugs as well as non-disclosed compensation to the PBM.

Pharmaceutical companies created copay assistance programs to lower employees’ out-of-pocket costs on medications. However, these programs do more than help insured employees afford expensive drugs. They also help prevent the pharmaceutical company from losing revenue paid by the employer on the medications. For example, for a brand drug that costs $1,000 a month and a plan design that has a member copay of $50, the pharmaceutical company may cover $45 of the member’s copay so the member only pays five dollars. This way the member fills the prescription and the pharmaceutical company receives $950 from the employer collecting 95% of the revenue. 

There are creative strategies that can leverage these programs into similar savings for the member but with additional savings for the employer. Our pharmacy consultants can show you how.

Pharmaceutical care can be complex. Having the right pharmacy partner can help you navigate the nuances of your pharmacy contract and negotiate an agreement beneficial to you. An independent pharmacy partner can evaluate not just the competitiveness of your PBM contract, but also the effectiveness of how well your PBM manages your cost exposure through their formulary structure and prior authorization process. Additionally, independent pharmacy partners give organizations access to services that the PBM may not be focused on, such as education, medication inspection, medication review, and pharmacy consulting.