Keith Bruhnsen, Visante senior consultant and assistant director and manager of the prescription drug plan at the university along with Libby Johnson, director, client & business analytics for Pharmaceutical Strategies Group (PSG) presented a webinar on April 26th sponsored by the Pharmacy Benefit Management Institute (PBMI) titled Managing the Pharmacy Drug Spend: A Client’s Perspective.
As the cost of healthcare, specifically drug spend, continue to rise, the University of Michigan manages to keep member cost share around 10%, compared to the national average of 22%. They have accomplished this by not sacrificing benefit quality, retail access or unaffordable out of pocket costs. Pharmacy benefit plans are complex to manage and Bruhnsen explained it’s critical to have a practical understanding and approach to both pharmacy pricing networks and formulary management.
In 2000, the university formed a group to develop and implement a plan to reduce costs and by 2003 launched a self-insured, self-administered drug plan. The members all have the same three-tier copay and coverage with no deductible and an annual out of pocket max of $2,500. In the first year, the plan saved $8.6 million.
Bruhnsen went on to explain that specialty drugs continue to be the key cost driver in most drug plans. The university takes a multifaceted approach by reviewing for inappropriate use, using a restricted pharmacy network, utilization management strategies, aligning the drug plan’s formulary with medical plans and inpatient hospital formulary, employing a maximum daily dose, and consulting with experts to name a few.
You can read the full article in the most recent Drug Benefit News.