An enhanced Prior Authorization program that resides behind an incumbent PBM. Cost savings are achieved through greater oversight of high cost medications.
The program highlights are:
- Protects the patient clinically
- No disruption for patient since we work directly with the prescribing doctor and PBM
- Protects the plan financially (typically reviewing 20% of drugs costing more than $2,500/mo.)
- Savings estimated at 10% of total drug spend
- No program fees; fees are contingent on approved savings