Can employers lower drug spending by limiting PBM involvement in health plans? 4 thoughts

While U.S. drug spending has steadily climbed in the past decade, Caterpillar has managed to lower costs associated with its employee drug plan by shifting reliance away from pharmacy drug benefit managers, reports Bloomberg.

Advertisement

Here are four things to know.

1. Ten years ago, Caterpillar — a leading manufacturer of construction equipment — assessed its employee drug plan and estimated as much as one-fourth of its $150 million drug spending was wasted, according to the report.

2. Instead of using PBMs, the company created its own list of drugs to offer health plan members and negotiated deals with pharmacies. Caterpillar also promoted the use of generic drugs — instead of costly heartburn and cholesterol drugs — and also hired its own pharmacists and physicians.

3. Since implementing these changes, drug spending has dropped both per patient and per prescription. Caterpillar now saves $5 million to $10 million a year on cholesterol-lowering drugs alone, according to Todd Bisping, a global benefits manager at the company.

4. While the company still uses the OptumRX to process claims and get rebates, Caterpillar’s strategy fuels the recent claim that PBMs are a major source of high drug costs in the U.S., reports Bloomberg.

More articles on supply chain:

Lawmakers seek to accelerate approvals with Reauthorized Generic Drug User Fee Act
Physician avoids high cost of EpiPens with homemade device
4 latest FDA approvals

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Register to Attend Webinar

Beyond the bottleneck: How health systems are improving access, flow and care continuity

Thursday, July 30
1:00 PM - 2:00 PM CDT

Presenters: Imamu Tomlinson, MD, MBA, VituityWilliam Morice II, MD, PhD, Mayo Clinic LaboratoriesJordan Dale, MD, Houston MethodistAsh Tengshe, City of HopeChris Klay, MHA, MA, PT, FACHE, Hospital Sisters Health System

Advertisement

Next Up in Supply Chain

Advertisement

Comments are closed.