Drug benefits comprise more than 20% of overall healthcare costs, which represents a large portion of a plan sponsor’s budget.1 For many plan sponsors, it’s important to balance lowering pharmacy benefit costs with ensuring minimal member disruption and increased satisfaction.
In fact, three-quarters of employers report that member dissatisfaction is the biggest challenge to implementing formulary exclusions,2 which could make switching PBMs increasingly complicated. But it doesn’t have to be.
Find out how one plan successfully reduced costs and improved service with enhanced benefits and cost savings opportunities for its members.
Overcoming Pharmacy Benefit Challenges
Despite the long-term relationship with its traditional pharmacy benefit manager (PBM), one university in the Midwest grew increasingly dissatisfied with the service level it was receiving. The university desired a PBM partner that was local, collaborative and allowed it to be involved in its pharmacy benefit decisions.
IMproving Client and Member Service
After a thorough evaluation of various PBMs, the university decided to switch to Navitus, a transparent, 100% pass-through PBM that has proven success in providing superior service and satisfaction to clients and their members.
The following key initiatives took place:
- Working Collaboratively
Made all benefit and program recommendations in collaboration with the university’s own Task Force Committee to ensure it was involved in all pharmacy benefit decisions and continued to provide the best offerings for its members. - Implementing Effective Communication
Members received robust onboarding communications through various methods to make available all benefit tools and information for a smooth transition to Navitus. - Lowering Pharmacy Costs
Implemented a modified plan design to help reduce a significant cost barrier that members were previously experiencing and promote effective health management.
Achieving Significant Savings
After transitioning to Navitus, the university experienced a 14% decrease in its total net cost per member per month (PMPM).
Want to see how they did it? Download the full case study to find out how the university successfully achieved significant savings across it pharmacy benefits while improving service levels.
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- Pharmacy Benefit Manager Customer Satisfaction Report. Pharmacy Benefit Management Institute (PBMI). https://www.pbmi.com/pbmsatreports. Published 2018. Accessed April 22, 2020.
- 2018 Trends in Specialty Drug Benefits Report. Pharmacy Benefit Management Institute (PBMI). https://www.pbmi.com/ItemDetail?iProductCode=SPECIALTY_2018. Published 2018. Accessed April 22, 2020.
- Pharmacy Benefit Manager Customer Satisfaction Report. Pharmacy Benefit Management Institute (PBMI). https://www.pbmi.com/pbmsatreports. Published 2018. Accessed April 22, 2020.
