PHARMACY BENEFIT INTELLIGENCE®

Taft-Hartley Case Study:

Taft-Hartley client – Savings Delivered: 29.64% plan savings to date

*Members continue to have flat dollar copay

Challenge

Northeast Taft-Hartley client retained PBIRx services in 2010 and directed that there be no change in members’ flat dollar copayment and that plan design changes have no member disruption.

Solution

On a continuum, PBIRx developed a multi-phase strategy to introduce various third-party programs and plan design cost savings programs with minimal to no member disruption.

The following phased-in strategy steps included:

  • Renegotiated PBM contract every two years increasing rebates and discounts.
  • Utilized proprietary algorithms to identify clinical programs, number of members affected, and estimated savings so that the union could make an educated decision on which programs to implement.
  • Performed annual PBM audits, negotiated with PBM, and facilitated recoveries.
  • Analyzed managed formularies for increased rebates, lower discounts, and member disruption.
  • Presented and analyzed value of removing major chain from network, resulting in deeper discounts, no member disruption.
  • Vetted and presented savings analysis for zero-member copay programs including a PBM manufacturer coupon program, international program, and specialty drug alternate funding program. PBIRx was very involved in each implementation to ensure positive member experience.

Result

Savings Delivered

29.64%

Plan savings to date

Members continue to have 
flat dollar copay

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