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WHAT OUR CLIENTS ARE FACING 

As of 2020, specialty drugs now account for over 50% of total pharmacy spend, and in 2021 alone, the FDA approved 50 new medications with an average cost of $185k. 

WHAT OUTSIDE VENDORS ARE DOING 

Most “Patient Assistance” vendors charge a percent of savings, with some being as large as 30%. 

HOW IT WORKS 

  • A carve-out of specialty medications from the employer-sponsored health plan through the Summary Plan Document
  • Enrollment of members in patient assistance programs provided by drug manufacturers. 
  • Members who qualify receive their medication direct from the manufacturer at $0. 
  • Members who don’t qualify will have their medication brought back on to the health plan.  They will still pay $0.
  • Plan pays a small flat PMPM fee rather than a percent of savings. 
  • Medications will have grace fills allowed to ensure no gaps or delay in coverage for your members.

CASE STUDIES

  • 1,200 member life group saw a $700K in savings.
  • 5,500 member life group saw a $1.5 Million in savings.
  • 90 member life group saw a $265K in savings.

Fill out the form below and a representative will be in contact with further information on NaviCareRx. 

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