We offer this comparison to our clients because we know that offering the best care to your employees is a high priority so we make it easy on you to choose the best and most cost- effective.
Below is an example audit of a Pharmacy Benefit Manager in which our PBM offered
is compared to another PBM.
These are real results from a client in which they saw almost 29% savings.
PBM Comparison
Client ABC
ETHOS PROPSED PBM “A” vs. ORIGINAL PBM “B” Envision: COST COMPARISON
Date Range of Claims 2/1/2015 to 1/31/2016
506 Employees
PBM “B” |
Proposed PBM |
PBM “A” vs. Envision |
|
| RX COUNT | 8,404 | 8,404 | |
| AVERAGE WHOLESALE PRICE | $2,324,720 | $2,324,720 | |
| INGREDIENT COST | $1,087,407 | $914,423 | ($172,984) |
| DISPENSING FEE | $4,300 | $2,887 | ($1,411) |
| ADMINISTRATIVE FEE | $42,504 | $48,576 | $6,072 |
| GROSS COST BEFORE REBATES | $1,134,212 | $965,886 | ($168,326) |
| REBATES | $0 | $137,672 | $137,672 |
| GROSS COST | $1,134,212 | $828,214 | ($305,998) |
| FINAL COST COMPARISON | -26.98% | ||
| Pharmacy Care Management Program Savings (30% Participation Assumed) | ($20,807) | ||
| Total Project Cost Savings changing to PBM “A” | -28.81% |
NOTE: The above cost comparison takes the clients claims at current contract and prices the claims at the PBM “A” contract. The above is not shown as guaranteed savings, but projects what the client’s current claims cost would have been, if they were in the PBM “A” under the PBM “A” contract.
Pharmacy Care Management Program (PCM)- This optional program engages physicians and members directly to ensure that the best possible drug therapies are chosen, based on their clinical effectiveness and overall cost to patient and the plan. PCM identifies prescriptions that can be switched to a lower cost, therapeutic alternative and works with a member’s physician to make the change.
Actual savings may vary based on group size and needs.