PHARMACY BENEFIT INTELLIGENCE®

Client Case Study:

National Employer Group — Total Savings Delivered: $800,000 Per Year

Challenge

  • Children (twin siblings) of an office supply company suffered from Gaucher’s Disease, a genetic disease requiring specialty drug treatments, with an annual cost of $800,000.
  • However, without notice, the hospital administering the drug doubled the plan price to $1.6 million per year.
  • PBIRx® was determined to find a lower-priced source for the drug after the hospital declined to lower the price.

Solution

  • PBIRx® uncovered two other viable options that would ensure continued treatment while significantly reducing costs. Both were met with resistance by the physician.
  • The first possibility involved home treatment administered by a nurse, however, the doctor refused to help and would not allow it. The second required bringing the children to a new facility, which PBIRx was able to negotiate the medication for half the price. Both the mother and the children preferred the new location after just two treatments.
  • PBIRx’s creative thinking and persistence resulted in a happy mother, happy children and lower costs, all with no disruption or threat to the children’s health.

Result

Total Savings Delivered

$800,000

Per Year

Share