Restructuring Contracts Without Benefit Distruption

Situation

This client was a mid-sized employer with 500 employees. The client was experiencing benefit cost increases that required a fundamental reset in their benefits approach; however, talent attraction and retention require a robust benefit. Their current Rx design was with a national carrier in a carve-in contract, and their annual pharmacy claims cost was $1.5m after discounts.

Solution

The ExudeRx team of Certified Pharmacy Benefits Specialists (CPBS) identified hidden sources of revenue the PBM embedded in the client’s contract. With a unique approach to contract structure and pricing, ExudeRx was able to lead the client to savings without a major benefit change.

Results

The total identified potential savings was 54%, or about $797,000. Specifically:

• Annual savings (discounts, rebates, fees): $498,953 (34%)
• Additional savings (including a minor benefit change): $298, 461 (20%)