Reducing Costs and Improving Service

Overcoming Pharmacy Benefit Challenges

Over time, one university grew increasingly dissatisfied with the service level it was receiving from its traditional pharmacy benefit manager (PBM). Despite the long-term relationship with its PBM, something needed to change.

Located in the Midwest, the university desired to find a PBM partner that was local, collaborative and allowed it to be involved in its pharmacy benefit decisions. This included finding a PBM solution to lower its pharmacy benefit costs and provide its members with superior service. Its desire for improved service, for members and at the account level, was a key factor for consideration during the evaluation process.

Finding a Long-Term PBM Partner

With high expectations, the university collaborated with its consultant to evaluate a number of PBMs that could deliver on its needs. After thorough evaluation, it decided to move forward with a partnership with Navitus. Several factors contributed to its decision, including the quality of service, cost savings, opportunities and location.

Implementing Effective Communication: To introduce the new plan, members received robust onboarding communications through various methods, including a welcome letter, an employee health and wellness fair, benefit newsletters and a custom benefit enrollment website. The customized benefit enrollment website allowed its members to preview their plan design options, formulary documents and cost compare tool prior to going live with Navitus.

Achieving Significant Savings

After transitioning to Navitus, it did not take long for the university to begin seeing significant savings. In the first year, its total net cost per member per month (PMPM) went from $87.56 with it previous PBM, down to $75.01, a 14% decrease.

Using a conservative forecast trend of 0.5%, the university saved an estimated $12.99 total net cost PMPM for the first year by transitioning to Navitus. This equates to approximately $700,000 in savings.