Caterpillar eliminates potential hidden revenue streams between PBMs and pharmacies by directly contracting with multiple pharmacy chains. This decision by the construction machinery and equipment company has brought substantial value to their plan and members with no negative impact on patient care or experience.
The University of Southern California
The University of Southern California (USC) reduced its drug spend by 40 percent in one year utilizing a higher value waste-free formulary. By refusing to accept the formularies offered by PBMs and designing their own, University of Southern California and a number of other employers, including Praxair and the Self-Insured School of California, had substantial plan and employee savings by rejecting the traditional PBM business model.
Albertsons saved over $200,000 per month by leveraging smarter procurement and better management of site of care to achieve a better patient experience and huge returns. Albertsons, a national chain of grocery stores with more than 250,000 employees, recently had an employee who had undergone a kidney transplant and was on a critical medication that cost the employer approximately $138,000 every two weeks. By taking advantage of their own specialty pharmacy, Albertson’s is now able to source this drug directly from the manufacturer for $26,092 every two weeks; with all patient cost sharing waived, it is a win-win for the patient and plan.
Albertson’s also had a pediatric patient receiving medication administered in a hospital in California for $750,000 annually. Rather than depend on the health plan, the employer searched the local market for alternatives and, with the agreement of the family, changed the treatment location to another California hospital. That same medication for that same patient at a different hospital cost only $250,000 per year.