A PBM may tout how many dollars you can receive due to their rebate program, but is that a good thing?

Many PBMs place drugs on their formulary or preferred drug list because of the rebates they get paid from the manufacturer. In some cases, this could be good and a savings for the Rx Benefit plan, but many times it results in the plan and the member paying more for medications with no clinical advantage.

For example, cholesterol reducing drugs like Livalo® which can cost about $ 750 for a 3-month supply versus generic atorvastatin at $ 25. Clinically there is no major difference in effectiveness. It’s like having a choice between two similar cars. Both can get you to work but one costs $ 20,000 and the other one costs $ 600,000.

Unfortunately, there are many (like over a hundred) similar examples like this. Imagine how much more you may be paying?

Working with Crystal Clear Rx (CCRx) and its state-of-the-art, proprietary software called “ClaimWatchRx” pulls all of your company’s current pricing and drug utilization data and compares that information with better options available in the market like the example shown above.

By using the analysis provided by ClaimWatchRx, we are able to advise our clients to remove products from their plans and cover cost effective products or generics for a fraction of the cost.

In the meantime, if you have any questions about your current drug pricing, please feel free to reach out to us anytime at 303-955-7827 or visit CrystalClearRx.com

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