There are many hidden ways that pharmaceutical manufacturers can increase the prices of their medications. One way is called parity pricing, which is when each unit of a medication costs the same, regardless of the strength. This means that employers may be overpaying for medications while adding no additional value for the member taking the medication.
One medication that uses this tactic is Imbruvica. Imbruvica is unique, as there is a capsule and a tablet form, and while there isn’t much difference in the usage of the different forms, there is a large gap between the prices. The capsule is much less expensive, but many times prescribers don’t know about the price difference.
A 3,300-life client in the technology industry had a member utilizing one Imbruvica 280 mg tablet a day, with a gross cost of $13,771 every 28 days. Upon identifying the claim using RxAnalyzer, an RxBenefits clinical pharmacist and RxBenefits Account Management Team performed an outreach to the prescriber
to optimize the claim.
The member was safely switched from one Imbruvica 280-mg tablet to two Imbruvica 140-mg capsules, which saved the client $4,642 per claim (gross). The client is expected to save over $55,000 annually thanks to this one simple change.