partners rx and bid rx how it works
DESCRIPTION
BidRx is a new alternative to the traditional pharmacy, connecting pharmacies across the country to compete against one another on individual member prescriptions. For plan members with Consumer-Directed Health Plans (CDH) or Health Savings Accounts (HSA’s), BidRx can help them to stretch their deductible even further by letting them have more control over what they pay for prescription drugs. Plan members enter their prescription on the BidRx website, review competitive bids including therapeutic alternatives, and then simply pick the lowest price. All in one easy transaction with savings of up to 97%. Getting the lowest price on prescription drugs has never been this easy. And it’s only available from Partners Rx.TRANSCRIPT
Combining our “lowest total cost” philosophy
with the power of internet bidding
Partners RxFull Service PBM
• Retail Network
− 60,000 Pharmacies
• Clinical Services
− Focused on Lowest Total Cost
• Mail Service
− Multiple facilities with expedited turn around
• Specialty Pharmacy
− Patient specific care coordination
• BidRx®
− Coordinated Pharmacy Approach
“We're In This Business Together.”
• It’s not just our tagline
• When we work together, we make prescription benefit management cost effective and user friendly
− Lowest total cost - average 10% savings
− Guarantee our savings projections
− Highest level of service
− “Open Book” management philosophy
− Partnership with producers
∙ Revenue sharing
∙ Value building business model
The MarketplaceChallenge #1: Quality benefits at a low
cost
Challenge #2: Balancing premium cost controls and keeping employee moral high
The degree to which you’re able to accomplish these things will help to differentiate you from your competition
Consumer Driven Health Plans (CDHP)Lower costs by involving the member financially in their care through the use of high deductibles and co-insurance
• Two significant problems− No efficient educational tool
− No competitive marketplace
Introducing
BidRx is a new web-based alternative for purchasing prescription drugs, providing dramatic savings by educating consumers and having pharmacies across the country compete for their business
How it Works
Plan member enters a prescription
Reviews competitive bids & therapeutic alternatives
Simply picks the lowest price
All in one easy transaction
With the convenience of having it delivered right to the members door
Perfect for…
HSA
High deductible
Co-insurance plans
Members on maintenance medications
Choose either…
“Coordinated” plan w/ Partners Rx as your PBMClaims are managed and reported by Partners Rx
Deductibles and coinsurance are kept updated
Access to over 64,000 retail pharmacies
Full complement of PBM services along with the convenience of using the internet w/ BidRx
Or, as a “Stand Alone” benefit where you may be able to offer BidRx all by itself
Let’s look at a typical plan member using
Diane is enrolled in a Consumer Driven Health Plan (CDHP)
$3,000 deductible
Partners Rx pharmacy benefit with the BidRx option
Office Visit / Lab Work $320
3 Prescriptions (90 day supply)
Lipitor® $380Nexium® $490Cymbalta® $350
Total Cost $1,540
An Expensive Day
Prescriptions were going to cost over $1200
It’s time to try
She’d Like to Spend Less
Begins by typing in the name of the first drug…
Then enters a few details from the prescription
Results of first search
Now she clicks “Get Instant Bids” to get a lower price
Delivered for $333.18
Not bad – she saved 12% or $47
But, BidRx also suggested some other less expensive options…
Simvastatin® … for $47.25
Calls the doctor to see if she can use Simvastatin® instead
Now she clicks on “Get Instant Bids” to see if she can get it for a lower price
$14.67 delivered!
She saved $365.33
That’s 96%
And it’s all delivered right to her front door at no extra charge
Original Original Adjusted Item Cost Recommended Total Savings
Lipitor® $380 Simvastatin® $14.57 $365.43 96%
Nexium® $490 Omerprazole® $56.78 $433.22 89%
Cymbalta® $350 Venlafaxine® $151.94 $198.06 58%
Total $1,220 Total $223.29 $996.71 81%
Diane saved $996 using
500 EE group (1,100 members)$500 to a $2,000 deductible
Monthly Annual
Present premium $295,000 $3,540,000
$2,000 deductible premium $191,750 $2,301,000
*Premium Savings $103,250 $1,239,000
BidRx Monthly EE Access Fee--$4.00 $2,000 $24,000(less than 2% of premium savings)
Net Premium Savings $101,250 $1,215,000
BidRx Prescription Average Savings—40% $7,700 $92,400
(33% BidRx Claims)
Net Rx savings $5,700 $68,400
*note on a self funded plan a reduction in the aggregate liability would occur similar to the premium savings and the Member Rx savings that occurred over the deductible would lower plan claims.
Financial Case for Diane’s Employer
All the benefits of Partners Rx PBM services plus the power of internet bidding
Great addition to any CDHP
Information and competition
Lower prices and better decisions
