The plan was suffering elevated pharmacy PMPM (Per Member Per Month). It needed a cost turnaround to survive in a Medicare-regulated environment.
How We Fixed It:
The client transitioned into PharmPix’s full PBM services. PharmPix then managed the client’s pharmacy benefits for the following 10 months, decreasing their pharmacy costs. . This represented a reduction of 20.6% from the previous year. From this reduction only 25% was due to pricing reductions.
Utilization reduction represented 75% of the savings within less than a year. Our client survived and thrived in their Medicare-regulated environment.