Case Studies

Medicare Cost Savings

Client: Medicare EGWP MA Plan

Medicare Cost Savings


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.

End Result:

Utilization reduction represented 75% of the savings within less than a year. Our client survived and thrived in their Medicare-regulated environment.

Medicare Cost Savings Medicare Cost Savings