SKYGEN’s Post

When employers choose traditional restriction laden pharmacy benefit companies, employees have few options to save on medication costs. Here are 3 things employers can do today to help employees afford medications -- 1. Demand an Rx claims report and engage an expert to help you analyze where you are getting overcharged. 2. Engage AI to understand if your PBM is compliant with their contract terms 3. Bundle medical and generic pharmacy costs through a monthly membership with a direct primary care practice. Bonus -- Bolt on alternative funding programs that ensure patients pay $0 and employers save up to 40% on Rx costs. What are your top action items for employers to save on drug costs? #healthcare #pharmacy #healthcareinnovation #patientexperience #medical

Did you know GoodRx has helped consumers save over $65 billion on brand-name and prescription medications since 2011? Our latest report on the GoodRx Effect walks through six main impacts that show how we are changing the economics of healthcare and well-being: https://lnkd.in/gWBU2rE6

Brokers can help employers manage rising healthcare costs with these three strategies. 1. Benefits Advocacy Services that can help employees comparison shop for care. 2. Prescription Drug Management Programs that aim to manage high drug prices. 3. Point Solutions that target specific health needs and high-cost claims Get more details by reading the full article on our blog:

The Healthcare Labyrinth is out! Chapter 34 of my book, The Healthcare Labyrinth, is a lengthy one on the big drug debate. I tell you how America has drug costs that are many folds higher than most developed nations. We have the highest prices for a number of reasons -- we do not set prices, we have a shadowy drug distribution channel, among many more. I also recommend some reforms to bring down costs -- patent reform, price transparency, channel reforms, reform of payments, importation, marketing reforms, drug price negotiations, and even international reference pricing/benchmarking. To tackle the elephant in the room -- whether drug price controls would impact innovation -- I recommend strategies to safeguard new drug creation. #healthcare #healthinsurance #healthcarereform #medicare #medicaid #medicareadvantage #aca #obamacare #exchanges #chip #universalhealthcoverage

The Healthcare Labyrinth is out! Chapter 34 of my book, The Healthcare Labyrinth, is a lengthy one on the big drug debate. I tell you how America has drug costs that are many folds higher than most developed nations. We have the highest prices for a number of reasons -- we do not set prices, we have a shadowy drug distribution channel, among many more. I also recommend some reforms to bring down costs -- patent reform, price transparency, channel reforms, reform of payments, importation, marketing reforms, drug price negotiations, and even international reference pricing/benchmarking. To tackle the elephant in the room -- whether drug price controls would impact innovation -- I recommend strategies to safeguard new drug creation. #healthcare #healthinsurance #healthcarereform #medicare #medicaid #medicareadvantage #aca #obamacare #exchanges #universalhealthcoverage

Weird headline but good article. Every little chip at the legacy PBM monopoly helps. Blue Shield may have found a crack and broken off a big ol’ chunk. We need more to do the same. More and more plan sponsors are coming to the same conclusion—that they don’t need a big PBM. Maybe the market can fix this monopoly if the FTC won’t. That would be the best solution anyway. #pbm #pcma #healthcare #drugpricing #pharmacy #pharmacist https://lnkd.in/ggZhjFmn

The GLP-1 debate is going to rage for quite some time to come, but I fail to see how this step by Cigna is anything to write home about. Capping annual increases for these drugs at 15% vs. the reported 40% is like saying that I'm still going to smash your thumb with a hammer, but it will be a smaller hammer. Here are some keys points to consider: If more employers cover these medications that run through their PBM, Cigna gets more in rebates and other related revenue. Bottom line, they make more. If more employers cover these medications, and they increase at 15% a year, it increases the amount of premium Cigna can charge, and profit Cigna can make due to the Medical Loss Ratio rules. Finally, in what reality is a 15% annual increase reasonable? At this point, the costs of development for these medications, which are simply renamed versions of a diabetes drug already on the market, has already been covered and/or is baked into the current price. The only justification for any annual increase is "because they can". I am not arguing for or against covering these medications, we believe an employer should be the one to decide if their plan covers them or not. My point here is that negotiating an annual increase of 15% is by no means a victory of any sort, nor a reason to cover the medications.

💊 GoodRx has a business model that we can all learn from. For those who are unfamiliar, GoodRx created a platform for comparing drug prices between providers and accessing discounts. They've took the hassle out of finding affordable prescriptions by offering a straightforward solution right at our fingertips. Even between similar companies (such as CVS or Walgreens), drug prices can differ greatly. GoodRx has found a way to help consumers access the drugs they need without breaking the bank. It's amazing how GoodRx tackles one of the most common healthcare headaches with such simplicity. What really impresses me is that GoodRx found a way to provide value by decreasing prescription prices while also growing their own brand. Startups need to have one question in mind: how can we provide undeniable value? If this question is answered, profits will follow. It's crucial to shed light on the challenges many face in accessing healthcare. Stories like Amber and Maya's highlight the urgent need for better solutions and advocacy for patients. #GoodRx #pharma #drugcosts #healthcare #digitalhealth

NEW SF SERVICE - Learn about Medicare Advantage and the choices it offers you for health care coverage, prescription drugs, and more.

The next prescription drug data collection (RxDC) report is due by Saturday, June 1, 2024. Employers should start reaching out to their issuers, TPAs or PBMs, as applicable, to confirm that they will submit the RxDC files for their health plans by this deadline. This Strategic Services Group (SSG) Compliance Advisor explains further. #benefitsconsultants #hrguidance #compliancespport #ssgmi #strategicservicesgroup #ssginsights