Rx Shock: Ever Faced A 900% Increase Nearly Overnight? You’re Not Alone.

We are finding some crazy Rx trends that are translating into real world cost and care issues for our clients and their employees. Here’s a prime example. We recently found that a type 2 diabetes drug (GLUMETZA) increased in cost by 900%, nearly overnight.

After digging into it here’s what we found:

• An investment firm purchased the manufacturer
• The price of the drug quickly spiked under the new ownership
• The drug had a specific efficacy but was prescribed widely

Clients are experiencing more of these types of prescription drug scenarios. In the past, these huge increases tended to run for a period of time then eventually make a return closer to previous price levels. However, some of the recent jumps in price have been holding at the higher levels.

What we did in this instance was work with the client to move the member onto a discount program, work with the pharmacy to give us alternatives, and then see if the provider could change the script. We found that all of this was satisfactory with the doctor and the member.

We have alerted our clients to contact us when these spikes in Rx hit their radar. If they would like help and are willing to collaborate, our medical claim advocate team will dig in and work to find a viable lower cost alternative.

As you might know from following the news, these actions by manufacturers are becoming big political topics. We don’t care about the politics, we care about finding the best ways for employers to serve their people and protect their bottom line.

“By taking the time to understand prescription drug trends and how the ACA is impacting the pharmaceutical industry, employers may be able to identify ways to reduce health care expenditures.” Read more about the impact of Prescription Drug Trends……Prescription Drug Trends 16_1



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