Trends in Clients’ Pharmacy Benefit Design for 2019

We fully appreciate that our clients are under mounting pressure to reduce members’ out-of-pocket expenses for prescription drugs, while finding ways to keep the overall pharmacy benefit plan affordable. To that end, we provide our consulting partners and self-funded employers with maximum flexibility in plan design to manage pharmacy costs. We are committed to bringing fiscally responsible solutions to the market, and we continue to evaluate the viability of emerging programs so that we can introduce you to additional win-win solutions.

97% of RxBenefits clients starting 1/1/19 implemented clinical programs for greater oversight on prescription drug claims. #NumbertoKnow #Rx

Myong Shipman

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An analysis of our book of business data for clients with a Jan. 1, 2019 effective date revealed some interesting statistics related to the national trends:

• 40% of the new pharmacy benefit plans have a high-deductible health plan option
• 97% also implemented clinical programs to provide greater oversight on prescription drug claims

These stats highlight the need to maintain affordability through an appropriate balance of plan design and clinical management strategies. A comprehensive pharmacy benefit strategy can help you ensure medication appropriateness while preventing unnecessary spending on high-cost drugs.

At RxBenefits, we provide tailored solutions to help make your clients’ pharmacy benefit plans more affordable and sustainable. Our approach focuses on lowering unit costs through client-friendly contracting, ensuring appropriate drug use through benefit plan design and data-driven clinical oversight, and providing superior service through high-touch client and member engagement.

Source:

RxBenefits Book of Business analysis, 2018 and 2019