Strategies to Improve Economic & Clinical Value in Pharmacy Benefits

for the Trucking Logistics Industry

 

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When the world around us runs smoothly with abundant supplies, food, fuel, and clean water we often neglect to appreciate the literal driving force keeping these everyday conveniences at our fingertips.

The Challenge

Virtually every trucking logistics company in the U.S. is challenged when it comes to implementing cost-control measures within a benefit program because there is stiff competition to acquire new drivers and, therefore, it is difficult to manage driver turnover. High driver turnover hurts profitability, making retention incentives like benefits and competitive pay extremely important.

Unfortunately, the industry’s 8M total U.S. employees have extensive and unique wellness challenges – especially its 3.5M professional truck drivers. Managing the health of a large and chronically ill employee population can create a financial burden for self-insured employers, making it critical to align the best benefits contract with professional prescription monitoring.

Major contributors to the most common health issues among drivers include:

  • Physical Limitations: confined to a cab for most of the day, limited physical activity, irregular/limited sleep
  • Dietary Restrictions: food options are limited and typically unhealthy, high-sodium fast food is the most available choice
  • Drug Access: long, tedious routes and schedules limit access to available refills and can impact adherence

Left unmanaged or under-treated, these chronic conditions can lead to more serious medical conditions and catastrophic events including heart attack, stroke, and cancer. The medical costs associated with these comorbidities is astronomical in comparison to the price of managing chronic conditions with drug therapy; however, drug therapy itself can become very expensive if not properly managed.

Here’s why.

In a recent survey by the National Institute of Occupational Safety and Health (NIOSH), over half of surveyed drivers had two or more of the following risk factors for long-term preventable disease: obesity, smoking, little physical activity, high cholesterol, high blood pressure, or less than 6 hours of sleep per night.²

Addressing Health Challenges Through Optimized Pharmacy Benefits

Since 2014, RxBenefits has, in partnership with our valued brokers and pharmacy consultants, aided 18 trucking logistics companies in solving these challenges by tailoring a pharmacy benefits strategy that better manages trend (the year-over-year change in drug spending) with minimal member disruption.

In 2019, the average trend for trucking logistics companies across RxBenefits’ Book of Business was -.02% which is 2.5% better than the trend for commercial plans managed by one of the largest PBMs. For every 1,000 members on a plan, this trend equates to $18,750 in pharmacy savings year-over-year versus a $51,250 increase for an annual savings of $70,000 or $5.83 per member, per month. This small example illustrates one of many savings opportunities available through RxBenefits. We work closely with your employee benefits consultant to identify additional clinical and contract savings, which is often greater than 25% of the pharmacy plan cost.

To optimize pharmacy benefits, we leverage a two-pronged approach that strikes the delicate balance between drug access and cost in order to cost-effectively manage the specific risks of the truck driver population.

  1. The pharmacy benefits contract includes competitive rates and rebates and client-aligned terms so the employer can purchase
    drugs at a fair unit price.
  2. The benefit is properly managed on an ongoing basis, having the right clinical oversight in place to approve good (appropriately
    prescribed and priced) and intercept bad (wasteful) prescription claims, based on the health and demographic characteristics of
    the specific member population.

Let’s breakdown two of the most prevalent health challenges in the industry – diabetes and smoking – and look at how RxBenefits is able to help trucking logistics companies address these challenges through optimized pharmacy benefits.

Diabetes

Diabetes affects approximately 14% of commercial long-haul drivers.² In fact, it’s reported that commercial truck drivers have a 50% higher risk of developing diabetes compared to the general population.³ Additionally, adherence is lower among diabetic commercial drivers at an average rate of 50% compliance.4
As a pharmacy benefits optimizer, RxBenefits helps companies manage the high costs of diabetes treatment while ensuring diabetic drivers have the appropriate medication at the right time. Through a combination of smart plan design and independent clinical oversight, HR leaders can tightly manage the higher costs of insulin drugs and promote treatment adherence and better self-management. Additionally, carefully crafted clinical programs ensure someone is always monitoring what is happening, assessing utilization data, and then optimizing the plan to ensure value and cost are in sync.

“The demands of being on the road can hinder a truck driver with diabetes from taking [their] medication properly or on time. Problems such as failing to organize medications in advance of trips, leaving town without getting a refill, or forgetting to pack them are frequent among truck drivers with diabetes.”

-Tom Milam, CEO, TrueLifeCare4

Step Therapy:

Designed to help find the best medication for the member, Step Therapy ensures diabetic truck drivers are getting safe, effective medication for their condition at the lowest possible cost for them and the plan. This may include the recommendation of generic or lower cost medications to treat their condition before moving to a second-tier drug at a higher cost. These recommendations are customized to the individual’s specific disease state.

 

High Dollar Claim Review (HDCR):

This umbrella protection guards against the inappropriate use of high-cost medications – especially related to the treatment of diabetes. If a medication exceeds
$1,000, it prompts a review of the prescription to protect against inappropriate medicine dosing, expensive off-label use, errors in quantity dispensation, waste, or stockpiling.

Retail 90:

Prescription benefit plans often include the option to fill maintenance medications for diabetes with 90-day supplies available through local pharmacies or mail delivery at lower costs to the member. Larger drug quantities available through a widespread pharmacy chain can aid in drug adherence.

$0 Copay:

Preventive medications can help avoid and/or manage many illnesses and conditions including diabetes. To help support the health of truck drivers, this pharmacy plan – available through the PBM – covers select preventive medication with a $0 copay.

Smoking & Tobacco Usage

Under such extreme physical stressors and/or lack of stimulation, truck drivers may turn to smoking or chewing tobacco as an unhealthy comfort or coping mechanism. The National Institute of Occupational Safety and Health (NIOSH) conducted a survey specifically on long-haul truck drivers and found that 51% of drivers were smokers, compared to 19% of the general population.2 This proves the problem of tobacco use in the truck driver population is a widespread and serious one.

$300,000,000,000
annual cost for smoking-related illnesses in U.S.5

While tobacco use itself isn’t a disease, its long-term effects can most certainly lead to critical diseases such as chronic obstructive pulmonary disease (COPD), heart disease, hypertension, cancer, and diabetes – to name a few. The high costs associated with the treatment and management of these chronic conditions can wreak havoc on a pharmacy plan.

The promotion of tobacco cessation programs is the best way to avoid costs associated with tobacco-related diseases – through preventive options such as nicotine replacement therapy, counseling, and prescription or OTC medications. When it comes to deciding what cessation programs might be appropriate and effective, RxBenefits’ world-class Account Management Team can provide options and best practices based on results gathered by other clients across our Book of Business.

Unfortunately, not everyone will quit using tobacco and many employees that have used tobacco for years will already be suffering negative health consequences. For this population, you can lean on advice from our team of clinical pharmacists, comprised primarily of PharmD’s (pharmacists who hold a doctorate in pharmacy). This team evaluates the medical necessity, appropriateness, side effect profile, and efficiency of prescription medications for these specific diseases to ensure members are on the best medications for their safety, at the best value for the plan. 

A Proven Track Record

When it comes to tackling the vast healthcare challenges of the truck driver population, brokers and HR leaders can count on RxBenefits to negotiate a highly competitive pharmacy benefits contract with one of the nation’s leading PBMs and deliver the clinical expertise and client-aligned programs needed to maximize savings with minimal member disruption.

“We couldn’t ask for a better partnership than the one we have with RxBenefits. Internally, we have a very lean HR team, and I’m the sole person in Benefits. Our RxBenefits Account Management Team is definitely an extension of my team, and I am truly grateful. I could go on and on about the transparency in costs savings, being there for our members, and everything that makes working with RxBenefits beneficial to our company. Personally though, I am even more grateful for the relationship I’ve built with the Account Management Team. I honestly can say they care about me and my success within the organization. It’s so great to have a personal, as well as professional, relationship with them. There may be many carriers and services out there, but not once have I even thought about exploring moving elsewhere. We truly are happy with RxBenefits and our plan.”

-Large Trucking Logistics Company

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Sources

  1. https://www.americanfreightinc.com/trucking-industry-statistics-for-2020/
  2. https://blogs.cdc.gov/niosh-science-blog/2015/03/03/truck-driver-health/
  3. https://www.atbs.com/knowledge-hub/trucking-blog/managing-diabetes-on-the-road#:~:text=A%202009%20study%20found%20that,meet%20
    tight%20schedules%20and%20deadlines
  4. https://www.fleetowner.com/fleet-management/article/21691327/diabetes-in-trucking-three-things-you-need-to-know
  5. https://ltsurvival.tumblr.com/post/134082354123

 

Fully Optimized Pharmacy Benefits
RxBenefits is the first and only Pharmacy Benefits Optimizer (PBO), serving as a trusted pharmacy adviser to employee benefits consultants and the pharmacy benefits solution provider of choice for self-insured employers. We offer employee benefits consultants a superior alternative to traditional PBM arrangements, combining market-leading purchasing power and contracting expertise with independent clinical advocacy to better manage pharmacy trend and keep the pharmacy benefit affordable. A high-touch service model ensures that clients, employees, and dependents receive exceptional care and enjoy a world-class benefits experience.