PHOENIX--(BUSINESS WIRE)--Magellan Rx Management, a division of Magellan Health, Inc. (NASDAQ: MGLN), today announced that its medical pharmacy management programs achieved over $2.1 billion in combined, lifetime savings for current health plan customers enrolled in disease-specific programs. These programs are designed to mitigate rising medical pharmacy spend while maintaining a high quality of care for members. Health plan savings have continued to grow over the years, and 2018 alone generated nearly $415 million in savings for nearly 20 current customers.
Proven solutions to identify and mitigate trend of medical pharmacy costs
Medical pharmacy trend and spend presents a unique set of challenges when compared to traditional pharmacy management. Medical pharmacy drugs, which are used to treat high-cost, complex disease states such as oncology, autoimmune conditions, and rare diseases, are administered by healthcare professionals in a provider’s office, in a patient’s home via home infusion, or in a hospital outpatient facility. Magellan Rx has leveraged advanced analytics, digital technology, strong provider network collaboration, and a robust knowledge of trend to develop customized, flexible, and quality-focused solutions to manage medical pharmacy drugs. The savings delivered to health plan clients are generated from clinical efficiencies and interventions identified by specialized clinicians across several high-cost, complex disease states.
“We have collaborated with numerous health plans on these pioneering medical pharmacy programs that optimize appropriate use, clinical appropriateness and effectiveness, patient adherence, and cost management for this complex and rapidly-growing portion of specialty drug spend,” said Kristen Reimers, RPh, senior vice president, specialty clinical solutions, Magellan Rx Management. “Individual plans experienced overall savings of 10-15 percent depending on their population size and scope of implemented interventions, including prior authorization, post-service claim edits, provider network strategy, site of service management, and medical formulary management.”
Magellan Rx medical pharmacy solutions bring together innovative programs and services that enable health plan customers to identify appropriate therapy, promote clinical efficiencies, improve quality of care for members, and—when combined with a targeted benefit design—reduce member out-of-pocket costs while increasing access to more convenient care.
- Programs now span multiple disease states across more than 200 specialty drugs on the medical benefit.
- New programs contributed to approximately 20 percent of total 2018 health plan savings, including dosing differential, drug wastage, as well as targeted solutions for intravenous immune globulin (IVIG), oncology immunotherapies, and hemophilia.
- The drug wastage solution specifically has driven an eight percent increase in savings over 2018 while positively impacting patient safety by eliminating unnecessary dosages and waste, with more than 350,000 units saved across a population of nearly 2,000 patients within the first year of the program.
- Additionally, in the last five years nearly 2,000 provider survey responses were collected with an annual average of 95 percent overall satisfaction in how the programs are administered, further demonstrating Magellan Rx’s collaborative approach to providing cost-effective and quality care.
About Magellan Rx Management: Magellan Rx Management, a division of Magellan Health, Inc., is a full-service, next-generation pharmacy benefit manager (PBM) that helps our customers and members solve complex pharmacy challenges by connecting them to the people, technology, and information they need to make smarter healthcare decisions. As experts in managing specialty spend both on the prescription and medical benefit, we are energized by discovering new and better ways to deliver solutions in today’s complex and rapidly-evolving healthcare environment, leading people to live healthier, more vibrant lives.
About Magellan Health: Magellan Health, Inc., a Fortune 500 company, is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com.