What is your PBM charging you for generic medications?

By admin / On Apr.14.2015 / In Generics, PBM Industry, PBM, PBM Auditing, Rx pricing, / Width

After a few years of moderate price increases, prices for the pharmacy benefit are once again, on the rise. According to a report released by pharmacy benefits manager Express Scripts, spending on prescription drugs in 2014 increased by 12 percent in the US, constituting the largest annual increase in more than ten years. The report attributed the sharp increases to the introduction of new, specialty medications, the new class of hepatitis C medications & drugs for multiple sclerosis. Express Scripts found that spending on specialty medications increased by an average of 38% across Medicare, Medicaid and commercial insurance plans. 
Crystal Clear Rx (www.crystalclearrx.com) Benefits Consulting, has consistently found another reason that may be contributing to increasing costs. The price your PBM is charging you for generic medications. The Express Scripts report forecasts that between 2015 and 2017, spending will grow by an average of 10% per year among commercial plans. This could be just a helpful warning. With some PBMs, this “news” is just one of many shrewd revenue strategies.
Did you know for example, Gabapentin 800mg has a range of pricing from $ 0.44 to over $ 10.00 per tablet/capsule.  Hmmmm, which price is your PBM passing along to you?
In any event, if you are spending 1 Million to 5 Million on your pharmacy benefit annually, you should prepare to spend an additional $100K to $750K next year…but you can do some damage control. 
Crystal Clear Rx can help you mitigate these price increases and perhaps, even stay below your current expenditure. It’s what we do best…we keep an eye on the fox, guarding your chickens. 
Give us a call to learn more about how Generic Rx pricing can be manipulated.
Check out our savings calculator for an idea of how much you could save annually.