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3 ways your employees can access medications for free - Part 3

Last week I sat down with Trevor Daer of Granite Peak Analytics to talk about how employers are saving 20% - 50% on their prescription drug spend.

During this webinar, we discussed 3 different programs the right prescription drug partners offer that allow your employees to access their highest cost medications for free. While a huge savings for employees, the bottom line impact for the employer is significant as well.

In the following clip, Trevor and I explore one of those programs, called Patient Assistance Programs. Learn more in the video above about Patient Assistance Programs and how one employer saved $24,500 (PER FILL) on 1 drug.

Transcript
All right you know the last one here let's talk about manufacturer coupons and and what they are and how we can use them and maybe why employers should tap into this now yeah yeah so manufacturer coupons is is another lever that that manufacturers have used on those high cost brand in specialty medications to basically help patients afford the medication so let's say I'm on Humira and right now that's about sixty four hundred dollars a month and my plan I have to meet my thousand dollar deductible which would be a miracle if my deductible was a thousand dollars these days and then I have a 200 copay so what that manufactured coupon does is the manufacturer again sets aside billions of dollars a year to basically incentivize and make it easy for patients to take their medication so they're not burdened so the plan is still kind of picking up the same amount of money but the patient is usually free or five dollars for you know six thousand dollars of medication so what we like to do is is deploy programs that let's say that same medicine has ten thousand dollars of manufacture coupon available but we're only taking advantage of 4 000 of it because that's how the plan design is structured so what we work with Mike and his plans to do is let's let's take advantage of the whole ten thousand because it's there and those are the those are the ways that we can not only help save the patient money because that they're typically already saving some money by using them but also benefit the plan and uh I hate to use the word free but right now the way the market is it's kind of free money if it's structured right and done well and again you don't have a bunch of middlemen in the in the middle taking a bunch of egregious fees it can usually save your health plan you know ten percent uh on Pharmacy spend really easily with with no abrasion or disruption yeah and I've actually seen you know this is a strategy um a couple of the big three will will actually still let you do right now International sourcing patient assistance program they're not going to allow you to do that but you know I I've seen in some plans that have the big three big three everybody is CBS Caremark it's ESI and it's and it's Optum it's optim RX that own 80 of the market share and with some of those you can actually turn these programs on and you should start to look at that if if you haven't that's an easy takeaway because these are these are not drugs that are are sourced you know from a different country these are drugs that are that are the exact same process as you go through today it's just applying these coupons these are the things that when an employee when a patient walks into a doctor's office they get a coupon that says hey use this to pay for your copay they've been out there for for a very long time we're just figuring out ways to use the balance of the coupon to benefit the employer as well.

About the Author

Mike Kroupa, Self-Funding Insurance Expert

I grew up in a house that was constantly under construction and the experience helped me uncover one of my passions, remodeling. After running a successful remodeling business with my brother during college, I decided I wanted to keep this as a hobby. Instead, I took my advisor’s recommendation and started down the actuarial path, which ultimately led me to insurance.
 
Since then, I have focused my career teaching employers how to better manage their health insurance plans. I found myself frustrated year after year of doing the same thing because it didn’t feel like I was making an impact. Healthcare costs were continuing to increase, and it felt like the only options employers were left with was increasing deductibles, increasing contributions, and switching carriers.

There was a turning point for me in 2020 as I found Health Rosetta, an ecosystem for scaling adoption of practical fixes to our health care system. As my clients started adopting these fixes, I found myself getting passionate about what I was doing for the first time. Then I realized my hobby of remodeling was driving the passion because I was remodeling health plans. Even better, I was having an impact because patients (employees, spouses and children) were getting the best care they ever have and saving a lot of money in the process.

Get in contact with Mike: 

Phone: 630.738.1835     Email: mkroupa@gocgo.com     LinkedIn: Mike Kroupa

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