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Reducing Benefits Costs with Minimal Employee Disruption

Situation

This client was a mid-size, regional employer. They were experiencing economic challenges and needed to significantly reduce its benefits cost basis- with a focus on Rx claims. They were with a national carrier “carve-in” arrangement with $1.9M in annual claims.

Solution

The ExudeRx team of Certified Pharmacy Benefits Specialists (CPBS) explored the degree to which the employer was willing to disrupt employees to save costs and learned that while cost was a driver, this employer was not willing to disrupt. We applied our sourcing model to create significant cost savings with minimal employee disruption.

Results

The total identified potential savings was 41% on the $1.9M in claims previously paid, or $603,000. Specifically:

  • Annual savings (discounts, rebates, fees): $410,812 (28%)
  • Additional savings via clinical, utilization and specialty Rx: $192,828 (13%)