THE PROBLEM WITH PHARMACY MANAGEMENT
The current focus of Pharmacy Management is on rebates and pricing gimmicks instead of the true cost drivers. This approach is limited in scope and only provides temporary results. What needs to be addressed are the real, long-term cost drivers of medication - Medication Adherence, Preventable Medication Injury, Polypharmacy, and Evidence-Based Cost-Effective Benefits Design.
of all newly prescribed medication is not picked up by the pharmacy
of all prescribed medication is never filled
increase in medication compliance can decrease healthcare costs by 4%
Adverse drug reactions have been costly to the American health system
costing human lives and $177 billion annually
Medication errors are the third leading cause of death in the U.S.
Annual estimated cost
Only 4% of patients have a conversation with their physicians about prescription cost
reduction in cost against a control group without intervention on polypharmacy
Wasteful spending by PBM’s formularies account for
of drug claims
Proper adjustments could decrease costs by
COMPLIANCE & COST
A patient was not taking her insulin as prescribed by her doctor – leading to non-adherence. Through a conversation, the pharmacist learned that the patient was on a high-deductible prescription plan, paying a percentage of the drug cost, and could not afford her insulin. The pharmacist introduced the patient to a direct insulin purchasing program, which brought her monthly cost down from $350 a month to $35 a month.
When patients pay a percentage of the drug cost versus a fixed copay, they should be motivated to call their pharmacist for cost-saving solutions.
THE ADVOCACY ADVANTAGE
Patients are often hesitant to question their physicians and typically fill (or don't fill) their prescriptions without checking or understanding their options. For example, a patient was taking a medication that was causing financial hardship and inconsistent adherence. After identifying the cost-related noncompliance issue, the pharmacist was able to contact the patient’s physician on his behalf and switch his medication from a higher cost “extended-release” version to a much cheaper “regular-release” version – increasing affordability and adherence.
Medications, generics included, can be deceptively expensive depending on dose or formulation – and moving a patient from one to another can result in significant savings.
PEOPLE FOCUSED PHARMACISTS
From a child's antibiotic to a parent's heart pills, our pharmacy team understands that each prescription carries the power to change a person's life. That's why we view medicine from the human side and strive to help our members understand their medications.
We also believe that no one should have to choose between medication and basic needs, or providing for their family. So we strive to find the best benefits possible for our members, saving them money and alleviating the stress caused by high prescription costs.
Our team is led by Luke Swintek, PharmD. A graduate of the University of Pittsburgh School of Pharmacy with more than seven years of experience in both retail pharmacy and ambulatory care clinical pharmacy. His driving motivation for becoming a pharmacist? To help people.
Imagine if choosing healthcare was as simple as buying a gym membership. Instead of buying lots of different equipment and paying for different services as you go, you pay once a month and get access to all the equipment, classes, and instruction you need.
That’s our model. For one monthly cost you get access to our Essentials membership, which delivers all the primary care you need - including services like sick visits, physicals, lab tests, telehealth, and over 200 generic medications. No paying for every single visit and service, no hidden costs or fees, no copays, no deductibles. It’s all included.
With our Prime membership, you get all that primary care and access to the advanced services of our Direct Care Network. This includes cardiology, physical therapy, imaging including x-rays and MRIs, durable medical goods like wheelchairs and crutches, and much more. Best of all, just like our Essentials plan, there are no hidden costs, copays or deductibles.
Our membership offers you more convenience and more care at a lower, predictable cost.
Visit PeopleOneHealth.com for more information.