The Challenge
A hospital in South Florida with 3,500 member lives had an annual pharmacy benefits cost of $4.5 million. The hospital wanted to optimize its prescription drug program to achieve its financial goals of enhancing margins and its human resources goals of improving employee satisfaction and reducing absenteeism.
$4.5M
annual pharmacy spend
The Solution
RxBenefits provided a comprehensive, conflict-free pharmacy benefits solution that addressed both the contractual and clinical challenges the hospital was facing with its previous PBM arrangement. RxBenefits conducted a Comprehensive Pharmacy Analysis of the plan’s previous arrangement to identify contract red flags and pinpoint the major trend drivers impacting costs. Hospital-focused strategies were implemented on top of that to leverage the hospital’s own cost of goods advantage and in-house resources.
Independent Contract and Clinical Oversight
- Accessed aggregate purchasing to secure competitive, transparent pricing terms
- Remedied pricing deficiencies and contract misalignments
Tailored Hospital Strategies
- Created a channel-agnostic benefit design
- Provided 340B and GPO support with “best-of” pricing
- Delivered population and disease management to optimize care
- Engaged the employee physician community
The Results
Overall Optimization Results:
Through a more competitive contract and the strategic support of a transparent pharmacy benefits partner, the hospital gained greater insight and independence over its prescription drug spending. RxBenefits’ comprehensive solution helped the hospital net a trend of 0% year-over-year, compared to a national trend of 10%.
24.4%
contractual savings ($1.1M)
5.5%
additional savings from clinical oversight ($250K)
$ 1.3M
Combined Savings (30%)
