NOTE: Individual states may allow importing prescription drugs, in conflict with federal rules. Enforcement of rules and liability of employers is an evolving issue. See the FDA’s personal drug importation summary.
Question / Intervention Goal / Objectives
Rx Manage, a voluntary mail-order pharmacy benefit, offers brand name maintenance drugs at a lower cost. The program imports drugs that are available from the same manufacturer or license holder at a lower cost than the payer would spend for a U.S. supplier. When lower-cost or generic drugs become available in the U.S., Rx Manage excludes them from the program. Employees pay no co-pay when they use the program and employers pay only if the services are used.
The applicant compared its final net cost for a sample employer client to a reference price set at 90% of GoodRx’s lowest price (including available coupons) in the state of Florida. GoodRx is a consumer search tool that lists pharmacy prices nationwide. Ninety-two prescriptions went through the program during the eight-month period of time.
Findings / Metric/ Outcome/ Savings
The employer paid 65% less for drugs purchased through Rx Manage than the reference price. Estimated savings for the eight-month period were approximately $106,000 which constituted 9% of their total drug spending for this time period. In addition, employees’ costs were reduced since no co-pay was required. These avoided costs were not estimated.
The program may have an impact on the purchasing volume for a plan’s Pharmacy Benefit Manager (PBM). This, in turn, could affect rebates and net costs. These effects are not addressed in the analysis.