716.688.5600

Prescription Drug Consulting

Prescription Drug Consulting

Premier Consulting Associates’ pharmacy management unit has more than 20 years of experience reviewing, negotiating, and managing client’s pharmacy programs with pharmacy benefit managers (PBMs). Pharmacy spend represents about 25 percent of overall health care spending and it is the most highly utilized part of a benefit plan, with approximately half of all members using the benefit on a monthly basis.

Premier analyzes member utilization and trends to determine the appropriateness for each client. As a part of this analysis, our team evaluates member cost shares, price discounts, rebates, utilization and generic dispensing. This allows us to determine the factors contributing to increasing plan costs. Each of these factors tells a lot about the covered membership as well as how a PBM is performing as a manager of the pharmacy benefit. Sometimes big changes create more harm than good, while small tweaks can save thousands of dollars.

We also monitor utilization of specialty medications on an ongoing basis. These specialty medications usually cost more than $2,000 per month and are prescribed to a very small and sick portion of covered members. Specialty medications currently represent about 20 percent of total pharmacy spending, but represent 50 percent of the drugs currently in the FDA patent pipeline. It is projected that specialty pharmacy will be the fastest growing portion of the medical benefit and will reach 50 percent of total pharmacy spending by 2020.

Premier has leveraged its book of business to negotiate standard prescription benefit management pricing which is significantly more cost effective than individual clients would be able to achieve on their own. This pricing is guaranteed, measurable and reconciled on an annual basis. Along with the enhanced pricing, clients will see higher rebates on a quarterly basis and a more controlled formulary encouraging members to utilize cost-effective medications first.

Click here to learn more about what Premier can do for you.

1416 Sweet Home Road
Suites 5 & 6
Amherst, NY 14228

716.688.5600

News & Views

Auditing Prescriptions and Medication Claims Can Save Your Plan Money

One of Premier’s Pharmacy Management Unit initiatives is auditing not only prescriptions filled through the pharmacy benefit but also medication claims billed through the medical plan to ensure that patients are prescribed medications that are both necessary and...