A therapeutic interchange saves $71,000 for a single patient treatment.
A state behavioral health program needed to reduce rising drugs costs despite experiencing a consistent increase in utilization. The organization operates on a tight budget and receives funding to assist with paying for uninsured patients. PharmAvail won a competitive bid to implement 22,000 members in three weeks.
Armed with this knowledge, we recommended:
• Using Patient Assistance Programs (PAP) for eligible brand drugs
• Implementing a tiered formulary
• Employing utilization management changes and prior authorization programs
Between 2017 and 2019, the state behavioral health program experienced:
30% increase in utilizers and 30% increase in prescriptions filled
30% reduction in PMPM
62% reduction in drug spend on brand (PAP drugs)