Drug Coverage: Control Costs With Managed Rx™

Drug Coverage
The Prescription Drug Challenge

Prescription drugs typically account for 70% of extended health costs. A new approach is needed to to help organizations of all sizes realize significant cost savings in their benefits plans – without cutting coverage.

The Managed Rx Difference

Managed Rx™ focuses on reducing two of the key cost drivers for prescription drug coverage: the drug costs themselves, and the dispensing costs.

Tackling drug costs with a tiered drug formulary

Generic drugs can cost significantly less than their brand-name equivalents. By introducing a list of approved drugs (this is called a “tiered formulary”) that encourages employees to choose generic drugs and lower cost therapeutic alternatives over brand name drugs, plans can realize significant savings. These alternatives are tested and approved to the same exacting Health Canada standards as their more expensive branded versions.

Tackling drug dispensing costs with a “Central Dispensing Pharmacy”

A Central Dispensing Pharmacy (or “CDP”) is basically a large centralized pharmacy. Since they deal in large volume, plans and plan members save through reduced ingredient costs and lower (and less frequent) dispensing fees. Both are a product of group purchasing power and reduced overhead. GroupHEALTH has partnered with a CDP to help our clients reduce their costs.

Putting it all together with Managed Rx

Managed Rx focuses on employee education to change behaviour – and lower costs. By making your employees active participants in how they access prescription drugs, Managed Rx™ encourages employees to purchase less costly, but equally-effective drugs through the CDP.

How Managed Rx works
  1. The employee tells their doctor that, for full coverage, they must purchase their prescription from GroupHEALTH’s CDP, Alliance Pharmacy
  2. The employee asks their doctor’s office to fax or call in their prescription directly to Alliance Pharmacy in their province, including the employee’s phone number on the prescription
  3. Alliance Pharmacy calls the employee to verify your order, and couriers the prescription directly to the employee’s home or work etc. – avoiding a drive to the local pharmacy and high dispensing fees

Learn More About How Managed Rx Works

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