Apex Benefits executives recently testified to the Indiana General Assembly’s Interim Committee on Public Health, Behavioral Health, and Human Services regarding Pharmacy Benefit Management (PBM) practices. The committee is tasked with reviewing factors contributing to Indiana’s growing healthcare and prescription costs in preparation for the 2020 session of the General Assembly.
Apex General Counsel and Vice President of External Affairs Todd Rokita and Vice President of Strategic Solutions Jim Harenberg shared Apex’ experience in helping Indiana employers make more informed decisions about their PBM contracts.
“We believe it’s our duty as advisors to provide sound, impartial business counsel,” Rokita stated. “On behalf of Apex, I appreciate the opportunity to tell you what we’re experiencing in serving as advocates to our clients, especially when it comes to gaining greater transparency in PBM contracting.”
Rokita asked that lawmakers address the need for employers to “see claims data in real time from the carrier, from the PBM, not just about pharmaceuticals, but about all healthcare claims” so employers can make better business decisions and achieve greater transparency into what they’re paying for.
He continued, “We live in an age now where we can have the technology that you can get data like this. And who owns that data? The employer, about their employees? The employees themselves or is it just the insurance companies? It’s shining that light into the dark recesses of the insurance world or the PBM world where we can start to make some savings and make a difference in the lives of people.” Hear more from Rokita (video clip).
In 2017, Apex established the ApexRx Pharmacy Benefits Program to help clients better understand their PBM contracts, demand greater cost transparency and mitigate escalating pharmacy costs.
Apex is the only benefits advisory firm in Indiana to employ a team of Certified Pharmacy Benefit Specialists (CPBS) who perform these PBM contract assessments to identify cost saving opportunities. These savings often involve the discounts and rebates that pharmaceutical companies pay to the PBMs.
“Employers are taking on the greatest burden for the rising costs of medications,” said Harenberg. “It’s our position that employers and/or their employees, to help reduce their financial risks, should benefit from the savings that are most often driving PBM profits.”
Through the ApexRx program, the Apex CPBS team has been able to save employer clients 15 percent to 45 percent on their pharmacy benefits costs without shifting costs to the employees, and typically with no or very minor changes to their benefit plans. See one case study here and here from Harenberg (video clip).
Read more about the testimony at Lakeshore Public Radio and also watch for more information from Apex. View the entire testimony (Apex starts at 4:05:30) archived on the Indiana General Assembly website.
For more information about ApexRx, contact firstname.lastname@example.org.