Pharmacy Benefit Management

A New Approach to Pharmacy Benefit Management

RxAdvance’s approach to managing pharmacy benefits is “data-driven” vs. “perception-creation” for plan sponsors.

If a plan sponsor is currently using a large PBM, RxAdvance has found that there is an opportunity to reduce pharmacy costs by 10%-12% by making small changes such as promoting untapped generics and adjusting from high cost to low cost generics. Just as well, there is an opportunity to reduce 40% of PBM operating costs through the use of a sophisticated platform, such as the Collaborative PBM Cloud™. Through the use of this holistic platform, RxAdvance is better qualified to manage risk than traditional PBMs.

Traditional PBMs have only recently begun to manage specialty pharmaceuticals after years of neglect. Due to their oversight, specialty pharmaceuticals have been driven to a poorly managed “buy & bill” model. By converting this to an “Value-Based & Outcome-Driven” model though RxAdvance’s nirvanaSpecialty™ service, plan sponsors could realize 10%-15% savings on overall specialty costs. A fully effective conversion utilizing RxAdvance’s streamlined 10-step program could further savings.

Due to traditional PBMs non-comprehensive approach, there has not been a single point of accountability in the care continuum. This oversight has introduced another $350 billion of avoidable drug-impacted medical costs into the healthcare system. Extensive research suggests that avoidable drug-impacted medical costs have exceeded overall pharmacy costs.  By acting as a true partner through its risk-sharing model, nirvanaAccountableCare™, RxAdvance is the only PBM capable of mitigating avoidable drug-impacted medical costs and managing the most unmanaged portion of managed care through risk sharing.

Traditional PBMs are not effectively and efficiently managing pharmacy, specialty, and avoidable drug-impacted medical costs. In order to truly manage these, you need a disruptive PBM player and a true partner, like RxAdvance, who looks at all of the costs holistically and through a lens driven by technology, data, and true partnership.

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