Integrity and savings that put you first
With prescription drug prices on the rise, you may be wondering which pharmacy benefit solutions truly deliver value for your bottom line and your employees.
As a health organization grounded in research, care and coverage, we use our deep understanding and experience to set up pharmacy benefit processes, strategies and checkpoints that drive market-leading drug prescription savings, create unparalleled member experiences and (most importantly) improve care. Our nonprofit roots guide our approach, ensuring that our clients and members always come first, never shareholders or other interests.
We’re also continually evaluating the market to ensure we’re always directing members to lower cost therapy options and pharmacies first. Plus, when manufacturers make formulation and dosage changes that create opportunities for savings, we follow suit – making sure our members can get the prescriptions they need at the best available price.
Integrate medical and pharmacy benefits for smarter cost management
When pharmacy benefits are integrated with medical benefits, costs are better controlled because programs and experience are managed across benefit plans, creating opportunities that can’t be obtained alone. That means the following elements can be more effectively leveraged to drive lower prescription drug pricing and more:
- Lowest net cost for prescriptions – Simply put, the more generics used, the lower your plan costs
- Preferred drug list – Prioritizing the most clinically sound and cost-effective drugs (usually generics), with both medical and pharmacy benefits in mind
- Prior authorization – Gatekeeping to ensure preferred drugs are dispensed in both medical and pharmacy settings
- Medication therapy management – Helping members manage multiple prescriptions through cross-referrals among medical case managers and pharmacists
- Savings – Manufacturer coupons and smart optimizing of significant potential discounts
- Site-of-care – Negotiating the most convenient and affordable places to get provider-administrated drugs and care
Here’s a quick glimpse of the benefits of working with our approach:
- Across the Midwest, HealthPartners risk adjusted pharmacy costs were 20.3% lower than average.
- In Minnesota, HealthPartners risk adjusted pharmacy costs were 19.1% lower than average.
- In Wisconsin, HealthPartners risk adjusted pharmacy costs were 23.4% lower than average.
A better pharmacy experience for plan members
Improving health and well-being is at the center of everything we do. So while our approach to pharmacy benefit management has been proven to save money, we’re even more proud of how it positively affects the lives of those we serve. By seeking the right solutions, not the simplest ones, we can
- Building long-term affordability – By emphasizing the use of lower-priced generics or biosimilars, we’re driving a more sustainable, cost-effective approach to prescriptions. For example, prior authorizations quickly examine the possibility of more effective and less expensive treatment options. And site-of-care optimization seeks places to receive the same treatments at more cost-effective, and often more convenient, locations.
- Increasing the effectiveness of treatments – Medication therapy management and case management strategies proactively look for more efficient treatments, less loaded with unnecessary prescriptions.
- Improving member service – Having pharmacy benefits integrated with medical benefits means a simpler, better experience for your employees. There’s no need to figure out which drugs are covered by medical or pharmacy benefits, just one carrier that takes care of it all with digital shopping and comparison tools, benefit navigators, and all-in-one plan management.
Taken together, it all means that when a member steps up to fill their prescription, they can be confident they’re getting the right drug, for the right price, for the right reason.