Some prescription medications are actually combinations of multiple drugs that make them significantly more expensive than if the component drugs were purchased individually. These combination products and compound kits, as well as some high-cost dermatologic products, can dramatically increase your total pharmacy benefit costs.
Identifying the Issue
Because of how they’re billed, you may not realize how much you’re paying for these prescription medications. Typically billed as a single product, they’re not easily recognized as a compound product that can be filtered out by most electronic claims reviews. Since most are priced under $1,000 per claim, they often fall below cost-per-claim restrictions that may be in place to help to reduce your total expense.
Reviewing Clinical Evidence
In addition to the significantly higher cost, published clinical evidence has failed to demonstrate that many combinations and compound kits work better than the individual products. You could be paying a much higher price for something that offers minimal or no advantage over lower-cost products available individually.
Reducing Unnecessary Costs
MaxCare’s SmartBlock is a unique and simple solution to this problem. It works by focusing on specific high-cost products whose components are available separately at a lower cost or through a simple compound medication at a minimal charge through a local pharmacy. Our clinical pharmacists developed this approach and continuously update it to include new drugs to the market that fall into this category.
At MaxCare, we believe your dollars should be used in the most cost-effective way to maximize pharmacy benefits for your membership. Our priority is to stay on top of pricing trends and provide solutions that will save you money while still taking care of your employees.
Contact us today to learn more about our SmartBlock program and other innovative clinical programs.
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