Success stories custom post type.
Overview Our client, an employer with approximately 8000 members and $9.75 million in annual prescription drug spend, was struggling to manage costs under their PBM program. They have provided prescription drug coverage with this large national PBM for more than six years and their contract included most of the PBM’s additional stand alone cost containment…
Overview A specialty prior authorization is an authorization by a PBM that allows a pharmacy to dispense a medication based on specific clinical criteria. However, if the medication quantity and day supply are not reviewed on a regular basis or accurately, there is a chance that the pharmacy may fill the medication more frequently or…
The Challenge When a mid-sized hospital system in central Louisiana was tasked with dramatically lowering pharmacy costs relative to national benchmarks for their industry, CobaltRx was engaged to find the best partner to meet the needs of this system struggling with rising health care costs. $13.28 PER EMPLOYEE PER MONTH The Approach This client valued…
The Challenge The increasing percentage of plan dollars allocated to pharmacy benefits has driven plan sponsors to seek ways to optimize the value of their spend. By better managing pharmacy benefits, plans sponsors can achieve cost efficiencies both inside and outside of the PBM structure. Faced with increasing costs and a dissatisfied employee population, a…
Misprescription Lorem ipsumof a patient who requested a prescription for Humira from a provider. The patient had been treated with nonsteroidal anti-inflammatory drugs (NSAID) for Rheumatoid Arthritis but asked the physician to prescribe Humira instead. The patient did not follow the treatment guidelines and did not have either the required TB or Hepatitis screening performed.…
Misprescription ELMCRx Solutions was asked to review the case of a patient who requested a prescription for Humira from a provider. The patient had been treated with nonsteroidal anti-inflammatory drugs (NSAID) for Rheumatoid Arthritis but asked the physician to prescribe Humira instead. The patient did not follow the treatment guidelines and did not have either…
Misprescription ELMCRx Solutions was asked to review the case of a patient who requested a prescription for Humira from a provider. The patient had been treated with nonsteroidal anti-inflammatory drugs (NSAID) for Rheumatoid Arthritis but asked the physician to prescribe Humira instead. The patient did not follow the treatment guidelines and did not have either…