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How to Manage Increasing Pharmacy Spend [Video]

By: Ryan Miller, May 9, 2017
 rx-drug-trend-vlog.jpgEmployer spending on prescriptions is climbing each year. Many (employers and employees) are left curious about the cause and unsure of how to respond. Employees want answers from their employers, pharmacies, and advisors. Are you prepared to offer context and guidance to them? Managing Director Paul Ashley and Advisor Ryan Miller discuss how employers can approach this conversation with their employees, and the tools available to aid them in the prescription landscape. Watch the video or read the transcript below.


Paul: Hello, and welcome to the FirstPerson video blog. I'm Managing Director Paul Ashley, and today I'm joined by Advisor Ryan Miller.

Ryan: Yeah, thanks for having me.

Paul: It's good to have you here. Today we're going to talk about prescription spend and one of the big challenges we've had. We've seen this shift happening, as employers are spending a higher percentage of their healthcare dollars, not on medical, but on the prescription portion. So this is increasing at a higher slope. And the cost of designer specialty drugs is a great influence. That's what's happening. What's driving that?

Ryan: Well, number one you've got to admit that it's a problem. That's an issue, that's something you're going to have to deal with. Prescription spend is never going to go away, but the shift is happening in what kind of prescriptions we're covering and what kind of prescriptions are driving that cost. And that's where you can be really impactful.

So these buyer-pharmaceutical medications are the ones that are becoming the hot-button topic. And the bottom line is these are specific drugs that treat autoimmune diseases and things that reach a finite portion of the population, which means you can't put a value on that. They are more expensive. So how do you determine what you cover, how do you make sure your people are using your drug plan the best way possible to save money for you and for your plan? And I think a lot of that comes with having a great strategy.

Paul: So what are some of the strategic thoughts that you have seen work with clients?

Ryan: First you've got to look big picture and start early. Because handling these kinds of conversations on what we cover on a prescription plan are much easier to have when you aren't talking about individuals that are going to fill specific medications. So it's about stepping back, taking a look at what we can do and what we can't do, and talking with your providers about how that works. And with your advisors to talk through that strategy.

And then it comes down to talking to your people, and making sure that you're educating people the best way you can. Education is critical because there are things you can talk to your whole population about, as opposed to those that will hit unique individuals.

Paul: When you look at 2017, 2018, and 2019 in particular, there's going to be a big boom in these specialty medications. Have you seen employers do anything specifically that is getting ahead of that and edits they can make within their pharmacy strategy?

Ryan: Absolutely. The edits you can make, or with a lot of things, is you can consult directly with your providers and consult with your pharmacy benefit manager (your PBM) about what kind of things can be turned on that maybe you've not turned on in the past. And then you spread your wings and you go outside of that scope. And that's when you start to see navigators, and you start to see help centers come in line. And these are places that you can send your people and they can be the experts to help them coordinate, and maybe get those same medications at a drastically reduced cost. And then an amazing impact of this is, most of the time these contracts people can end up in, they can go with them. They don't have to be something that's leveraged through your employer uniquely. Which means that you can eliminate or limit the folks that maybe hold on to your medical over a long period of time and stay with you as an employer based off just the benefits you have access to. This can be something they negotiate directly and carry home with them and keep that low cost in place, because these are drugs they're going to be on for the rest of their lives.

Paul: So that's the medication-therapy management, that's the sort of broad area. The other thing you'll see is technology come in to play that's a direct consumer tool. Some of your favorites are what?

Ryan: Absolutely. We use OneRx and GoodRx, the two that have really risen to the top of the list. And to be fair that technology around this space has existed for a long time, however, how much can you trust it? Whenever you're an employer, you're working with something that's an open source technology resource, you know it's a referendum on you. You're asking your people to go out and take a look. The bottom line is that nowadays those things are much more consistent, they're a lot easier to use and utilize, and they're going to give great information to people. Feel free to use them and push that information out to your people so they can be utilizing that information and resource long-term. Understanding your benefits goes beyond where you work, these medications and these situations come up all the time.

Paul: Yeah, and they partner really well with consumer-driven health plans, how to deduct wages in compatible plans. A couple takeaways we have:

  1. Empower your employees to be thoughtful. If they understand how our prescription works they're going to be better educated and make better decisions.
  2. It will also help to prevent employees from staying just because they need your benefits.

Thanks for joining us for this video blog, a focus on Prescription Trends. We look forward to connecting with you next time!

Categories: Video