1. The Rx for Rx Savings Breaking the Status Quo!
August 15, 2018

2. Employers’ Choice Rx RxResults, LLC Sales/Marketing Account management
Rx claims processing
Pharmacy network(s)
Specialty pharmacy
Drug coverage initiatives
Prior authorizations
Rebate administration
RxResults, LLC

3. About
RxResults, LLC

4. About RxResults Evidence-based recommendations
Partnership with UAMS College of Pharmacy
Non-biased peer-reviewed literature/studies
We don’t recommend chasing rebates
Plans shouldn’t sacrifice lowest net cost to maximize rebates
Plans should get rebates where they make sense
Exclusive formularies are often not as good as they seem
RxResults, LLC

5. About RxResults Our only revenue is from administrative fees
We don’t make more money for preferring one drug over another
We make no revenue from PBMs or Pharma
We continuously look at the industry’s drug mix to protect plans from new marketing trends
RxResults, LLC

6. Risk Management Strategies
Evidence-based medicine based on non-biased independent review
Peer-reviewed literature used for comparison of therapy choices
Application of national practice guidelines
A focus on outcomes of care not just individual cost components
Reference pricing, prior authorization, step therapy, quantity limits, and exclusions
RxResults, LLC

7. Specialty Drug Prior Authorization
Non-biased prior authorization reviews
Many PBMs have a conflict of interest
Coverage not approved simply because a patient has a condition for which the drug has an FDA-approved indication
Existing patients are grandfathered
Smooth handoffs to specialty pharmacy for medication delivery once approved
Internal appeals handled by RxResults
RxResults specialty PA approval rate is 68% compared with many PBMs’ approval rates of 83-93%
RxResults, LLC

8. Pharmaceutical Manufacturer (Pharma) Trends
RxResults, LLC

9. Pharma Trends
Combination Drugs
Combination of older generic drugs to make new patentable brand drugs
Examples:
Duexis® - $2,394 per 30-day supply
Combination of ibuprofen (Advil®) and famotidine (Pepcid®)
Single ingredients per 30 days
Ibuprofen: <$10
Famotidine: <$5
RxResults, LLC

10. Pharma Trends Combination Drugs
More examples:
Vimovo® - $2,462 per 30-day supply
Combination of naproxen (Naprosyn®, Aleve®) and esomeprazole (Nexium®)
Single ingredients per 30 days
Naproxen: <$5
Nexium 24HR® : <$18
Treximet® - $791 per 30-day supply (9 tablets)
Combination of naproxen (Naprosyn®) and sumatriptan (Imitrex®)
Single ingredients
Sumatriptan: <$14
RxResults, LLC

11. Pharma Trends Packaging (Kits, Paks, etc.)
Packaging drugs with other products or other drugs
Examples:
Tretin-X® - $256 per 30-day supply
Tretinoin cream, cleanser and moisturizer
Tretinoin cream: $10
Low-cost cleanser and moisturizer available without prescription
Lansoprazole/amoxicillin/clarithromycin therapy pack $397 per 14-day supply
Lansoprazole (OTC): $16
Amoxicillin: $6 $48
Clarithromycin: $26
RxResults, LLC

12. Pharma Trends Delivery methods
Using older generic drugs to make new brand drugs with different delivery methods
Examples:
DermacinRx® LexitralTM PharmaPak- $3,289 for 30- day supply
Diclofenac and capsaicin applied as drops
Diclofenac tablets: $18
Capsaicin cream: $6
Intermezz0® - $243 per 30-day supply
Zolpidem (Ambien®) as a sublingual tablet
Zolpidem tablets: <$3
RxResults, LLC

13. Pharma Trends Delivery methods
More examples – tablets vs. capsules:
Generic venlafaxine ER (Effexor XR®)
Tablets: $253 for 30-day supply
Capsules: $19
Generic tizanidine (Zanaflex®)
Capsules: $75 for 30-day supply
Tablets: $14
RxResults, LLC

14. RxResults Performance with ECRx
(2011 – 2018)
RxResults, LLC

15. ECRx Employer Plans Targeted Drug Classes Only
2010
2011
2018
Avg Mbr Paid/Rx
$13.09
$12.19
$11.96
Avg Plan Paid/Rx
$48.90
$36.59
$20.00
Drug Cost/Rx (Avg Rx)
$66.91
$48.78
$31.96
Generic Utilization %
71.51%
76.21%
96.17%
RxResults, LLC

16. ECRx Employer Plans All Drugs/Claims
2010
2011
2018
Avg Mbr Paid/Rx
$12.04
$11.49
$13.15
Avg Plan Paid/Rx
$50.21
$44.74
$45.18
Drug Cost/Rx (Avg Rx)
$62.25
$56.23
$58.43
PMPM without Specialty
$74.60
$49.28
$31.47
PMPM with Specialty
$82.52
$60.22
$45.29
RxResults, LLC

17. Average Plan Paid per Rx All Drugs/Claims
Projected without ECRx
$50.21 (actual)
$72.42 (assumes 5% annual growth)
Actuals
$50.21
$45.18
- $27.24/Rx less than projected
- At 10 Rxs per member, $23.70 PMPM / $272 PMPY savings
- At 2 members per employee, $45.40 PMPM / $545 PEPY savings
RxResults, LLC

18. Thank You
RxResults, LLC