Tackling Drug Costs + Safety One Program At a Time

How We've Saved Nearly $1 Million

We know drug costs are one of employers’ and employees’ top concerns. So we’re tackling the problem from all sides, using a range of proactive and innovative strategies to help control pharmacy costs and increase safety. And every day we keep looking for more ways to control costs on every front, including specialty prescription drugs. Our goal is to ensure members get the best, most appropriate care.

We know drug costs are one of employers’ and employees’ top concerns.

Nearly $1 Million Saved

One recent example of this innovation is our prior authorization program for the chemotherapy medication Neulasta®. This drug is used with high-risk patients receiving chemotherapy to reduce the risk and duration of neutropenia-related events (an abnormally low number of white blood cells). However, using the medication for patients at low to intermediate risk is not clinically indicated—and poses increased side effects, risks and costs without clinical benefit.

To limit risk to members from unnecessary treatment, we implemented a prior authorization program on October 1, 2017, and prescriber behavior change demonstrated a positive response. As a result, the program improved clinical safety, mitigated overutilization and cost, and resulted in savings of nearly $1 million for our Commercial fully-insured business.* It’s specialty pharmacy programs like these that work behind the scenes every day to help reduce costs while making sure members safely receive the right care at the right time.

 

*The savings compares the period of October 1, 2017 – March 31, 2018 with the period of April 1, 2017 – September 30, 2017.

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