Andrew Suittor’s Post

Employers and consultants should start discussing strategies on how to navigate the newest class of medications used for weight loss. We dig into potential cost considerations, insight into other reasons these drugs are being prescribed, and ideas to mitigate costs when coverage is offered. Need additional guidance? Reach out to MakoRx for a clinical and financial analysis for your health plan and unique member needs. #healthcare #pharmacy #healthcareinnovation #patientexperience #medical

The PBM Conflagration Marks the Beginning of Healthcare's Center-of-Gravity Shift - with the recent FTC report on PBMs, state lawsuits accusing the same of overcharging, and more employees suing their employers over poor health plan management, the fuse for major change has been lit. Healthcare's center-of-gravity is shifting and the tectonic movements happening right now herald a new era for those of us purchasing healthcare, those of us consuming it, and those of us trying to make it better. These are exciting times. https://lnkd.in/gdM769Cz Northwind Pharmaceuticals #HealthStewardship #employerbenefits #PBM #ClinicalBlueprints

The world is changing for group health plans, with a surge in class action lawsuits grabbing headlines. While this presents challenges for benefit managers, it also opens doors to transformative opportunities in plan designs, administration, and vendor selection.   Example: the current structure of prescription drug benefits often sees rebates flowing back to employers, who then allocate these funds to various initiatives. However, the lack of transparency in rebate arrangements, particularly with expensive specialty drugs, places a disproportionate financial burden on the sickest members of the plan. In essence, those with the greatest healthcare needs end up subsidizing the costs for healthier individuals.   These challenges pave the way for innovation and disruption, now with eager support from company leadership. This is the time to renew focus on equity, transparency, independent plan audits (claims & eligibility), disciplined claims data analysis, and proactive (documented) vendor selection and management.  

Pharmacy costs remain a top concern for employers, with high-cost drugs in the pipeline and overall cost trends weighing heavily on budgets. As healthcare dollars allocated to pharmacy expenses continue to rise, it's crucial for employers to adopt strategic management approaches. Applied Health Analytics is committed to providing comprehensive solutions to navigate these challenges and ensure affordability for all. #populationhealth #populationhealthassessment #populationhealthdemands #populationhealthinitiatives #populationhealthmanagementservices #populationhealthneeds #populationhealthstrategy #populationwellbeing #providercentricpopulationhealthinitiatives #reducehealthcarecosts

Weight loss drugs impact employer health spending! A recent analysis reveals that the use of weight loss prescriptions is contributing to a significant increase in health costs for employers. Weight loss prescriptions are estimated to increase healthcare spending from $324/ member in the current year to $500/member in two years. In 2021, annual spending on such prescriptions was $96 per member. These GLP-1 drugs have been identified as major contributors to the increase in health spending. ✔️Wegovy ✔️Rybelsus ✔️Saxenda ✔️Ozempic With more drugs gaining FDA approval for weight loss, there is an expectation of increased demand. As the landscape evolves, stakeholders will need to explore strategies for managing healthcare spending effectively. What do you think? Ray Hahn, Christin Dostalek, Joel Relampagos, Berkeley Dains, CATClll, CIP, Dean Sawyer #HealthcareCosts #HealthcareSpending #WeightLossPrescriptions #GLP1Drugs

For most employers, the new RxDC medical benefit files don't provide new information. https://bit.ly/4a0qxUS However, the #pharmacy files now include data not typically provided, such as PBM profit margin, drug level rebates and manufacturer cost-sharing assistance. We explain what this means for employer sponsored #health plans in 2024. #healthcare

Prepare for Pharmacy 101 with CBIZ! Join our experts for a complimentary #webinar to explore the world of Pharmacy Benefit Managers. Discover how contractual details influence your population's health and your plan's expenses. #pharmacy #pharmacybenefits #HealthcareSolutions

The primary benefits of #EPrescribing can be seen in three key areas: ✅ Reduced prescription drug misuse ✅ Improved medication adherence ✅ Fewer medication errors The benefits in these areas alone represent the potential for hundreds of millions in annual savings for the health system.

For most employers, the new RxDC medical benefit files don't provide new information. https://bit.ly/456a68R However, the #pharmacy files now include data not typically provided, such as PBM profit margin, drug level rebates and manufacturer cost-sharing assistance. We explain what this means for employer sponsored #health plans in 2024. #healthcare

For most employers, the new RxDC medical benefit files don't provide new information. https://bit.ly/3x4QbtH However, the #pharmacy files now include data not typically provided, such as PBM profit margin, drug level rebates and manufacturer cost-sharing assistance. W explain what this means for employer sponsored #health plans in 2024. #healthcare