INDIANAPOLIS--(BUSINESS WIRE)--As rising drug prices and health care spending continue to outpace the economy, the first drug trend report from IngenioRx demonstrates that, by analyzing information about drugs costs prescribed to consumers through both their Medical and Pharmacy benefits, health plans can implement effective programs and care management strategies that will limit additional drug price increases and may reduce costs.
IngenioRx is the stand alone PBM established by Anthem, Inc., one of the nation’s leading health benefits companies. The IngenioRx report, titled “Taking a Total View,” analyzed both Medical and Pharmacy claims information on prescription drugs provided to consumers through Anthem’s affiliated employer-based health plans in 14 states. The report demonstrated, with access to both Medical and Pharmacy Claims, overall 2017 drug costs increased by only two percent. Without the ability to manage both Medical and Pharmacy claims, the same drug costs for 2017 would have increased by six percent.
“Taking a Total View” represents the first comprehensive study of drug costs covered under both the Medical and Pharmacy benefits of consumers rather than only the Pharmacy benefit,” said Colleen Haines, Vice President, Clinical and Specialty Pharmacy, IngenioRx. “Because IngenioRx is able to access the data from both Medical and Pharmacy benefits, we have a full picture of drugs used by consumers. This allows us to more accurately assess the total drug trend and develop the right programs and strategies that can lead to better health outcomes and more affordability for consumers and employers.”
The report also demonstrated that the combination of insights from both Medical and Pharmacy provided enhanced visibility to changes in medication use and drug costs. The cost of a drug can vary if it is covered under a Medical vs. Pharmacy benefit and also based on where the drug is administered. For example, the report identified that 94 percent of the dollars spent on immune deficiency drugs and 63 percent of the dollars spent on cancer drugs were paid by the Medical benefit instead of the Pharmacy benefit.
“The rising price of drugs is a concern for the entire health care system as the impact of this cost is felt and paid for by all of us,” said Deepti Jain, Chief Operating Officer, IngenioRx. “That’s why it’s so important to have a deep understanding of actual drug use and costs. Having access to the total view is critical to knowing how to implement benefits, evidence-based drug lists and programs that result in improved health outcomes, while keeping costs affordable as possible for all Americans.”
IngenioRx will provide pharmacy benefit management services to payers, including affiliates of Anthem, Inc. (ANTM). IngenioRx brings new clarity to the complicated world of pharmacy so members get the benefits they need in a way that’s simple and seamless. IngenioRx will offer a whole-health approach that helps drive better outcomes and lowers member, employer and plan costs. IngenioRx will focus on delivering a member-centric solution that’s aligned with our customers and transparent in formulary and clinical decision-making. For more about IngenioRx, go to https://www.ingenio-rx.com/.