How One Firm Saved 48% on Their Prescription Drug Spend

How One Firm Saved 48% on Their Prescription Drug Spend


You may be surprised by what you can save in pharmacy costs with a little negotiation. For example, one Miller Group client has saved 48% thanks to prescription benefit manager (PBM) negotiations.

This 1,000+ employee firm trusts their advisors to keep their pencils sharp and always make sure they’re getting the very best deal on their prescription program. Part of doing that is finding savings where they may not be expected.

For example, thanks to negotiations with the PBM, the client received deeper discounts (lower plan spend), higher rebates and new programs. All told, they were able to find more than 48% in savings this year.

Self-funded companies can benefit from multiple tactics to manage their prescription costs.

PBM Pricing Changes: PBMs get new, updated discounts and rebates twice a year. If you have a three-year contract that does not include escalators or if you passively renew your PBM contract each year, you’ll miss out and leave money on the table. It pays to take an active role in each contract renewal.

Carve-out programs for specialty and high-dollar prescriptions: You can carve out an expensive brand and generic medications from your prescription drug program These programs can be offered on a voluntary or mandatory basis. When your members fill their medications through alternative sources, they pay nothing. You’ve moved the risk off your plan and removed up to 100% of the cost from your bottom line.

Point-of-sale or rebate credits: PBMs will often agree to give you some of the expected rebate dollars up front in the form of drastically discounted ingredient costs or per-employee, per-month credits. At the end of the year, if anticipated prescription rebates come in lower than expected, the PBM absorbs the loss. If they are higher than projected, you get the additional rebates on top of the credit. Our clients use their immediately available rebate dollars to offset medical plan costs.

Opportunities for pharmacy savings are out there, but you’ll only get them if you ask. The Miller Group is happy to help you consider these options and negotiate with your PBM on your behalf.


By Tracy Johnson, Director of Pharmacy Benefits, Employee Benefits

See also:
Pharmacy Cost Management: 5 Tips for Managing Your Pharmacy Benefits Partner
Pharmacy Cost Management: Can You Benefit From Recent FDA Guidance On Biosimilar Replacements?
Pharmacy Cost Management: How To Make Pharmacy Discount Cards Work For You And Your Employees

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