[ECB Rx] Rx ‘n Go
Question / Intervention Goal / Objectives
Rx ‘n Go is an alternative pharmacy program that helps pioneering employer groups reduce prescription medication benefit cost (for both the plan and members), add relevant member health benefit choice, and positively increase prescription medication compliance. Rx ‘n Go offers mail-order maintenance medications, priced at four standard price tier levels – $25, $50, $75, or $100 for a typical 90-day supply (mailed to the member’s home). Employees pay nothing; the employer or plan pays one of the four price levels only when members use Rx ‘n Go to fill their chronic prescription medication needs. Note: VI’s review was exclusively on the reduction in costs; no other statements were reviewed.
The analysis focuses on how Rx ’n Go’s streamlined pricing saves both the health plan and its members money, taking into account that in some cases, Rx n Go’s price may be higher than other sources.
For a 5,085-person group, the analysis compared the Rx ‘n Go costs of the generic medications with what the plan would have paid for the same medication using the health rates. The analysis calculated: the total amount paid, the amount the health plan paid, the amount the employee paid, the per-day’s supply cost, and per prescription costs. The analysis was limited to generic medications purchased through the Rx ‘n Go program. Cost for non-users of the Rx ‘n Go program were not analyzed.
Findings / Metric/ Outcome/ Savings
In 2018, the plan, and its members spent $166,824 on generic drugs through Rx ‘n Go; the plan and members would have paid $327,231 for the same drugs, if they had purchased the drugs under their PBM (non-Rx ‘n Go) contract. Of the $160,407 in actual savings, members saved $103,061 in avoided co-pays (because the Rx ‘n Go program requires no co-payments from members), and the plan saved a total of $57,346. For the case study group, the Per Day’s supply and Per Prescription costs for the drugs purchased through the Rx ‘n Go program were 49% lower in 2018.
Any particular employer’s actual savings from adopting the Rx ‘n Go Alternative pharmacy program will vary, depending upon its existing pharmacy contracts and utilization mix.
The analysis did not address whether the plan’s costs for other medications (brand name, non-maintenance, or generic medications not handled by Rx ‘n Go) were affected by moving the generic drug volume away from the Pharmacy Benefit Manager (PBM). Moreover, the analysis does not include any savings from increased member medication compliance.