Our customized, targeted cost containment strategies are designed to help eligible individuals access savings for high-cost medications and improve adherence while supporting organizations’ efforts to reduce their health plan’s prescription drug and medical costs.
The PAP programs provide access to funding from manufacturers, philanthropic associations, and other sources for high-cost specialty and branded medications at no cost to the plan or the member. Our team of coordinators determines whether there is funding for specific drugs and works with the plan, patient, and funding source to dispense the drug.
The Dialysis Carve Out program includes case management services that are designed to identify at-risk members before they need dialysis. The program features case management services that are complemented by our proprietary plan language and reasonable value payment re-pricing methodology to help provide cost savings and protect plan assets when members progress to End Stage Renal Disease (ESRD).
The Gene Therapy Solution is a cost-containment program that when coupled with stop-loss coverage, provides a sustainable, evolutionary strategy that prepares employers to face unexpected, high-dollar gene therapy claims with confidence. Our Gene Therapy Solutions’ program management team works with the industry leading resources to evaluate the efficacy and impact of available therapies.