Say No to High-Cost Drugs

When it comes to employer-sponsored healthcare, one of the most significant cost drivers is prescription drugs. The traditional Pharmacy Benefit Managers (PBMs) that dominate the industry—CVS Caremark, Optum RX, and Express Scripts—operate with a business model that prioritizes profit over transparency and cost-effectiveness, exceeding a whopping $400 billion dollars in combined revenue in 2022. This has led to skyrocketing drug prices and a lack of clarity in pharmacy benefits management.

At Snellings Walters, we are committed to providing our clients with better health plan options that align with their needs and values. One way we achieve this is by partnering with SmithRx and Mark Cuban’s Cost Plus Drug Company, two organizations committed to revolutionizing the pharmacy benefits landscape through affordable medications. Read on for a fascinating take from our Employee Benefits Principal Tara M. Byrd as to why this partnership matters and what it means for you.

The Problem with the Big 3 PBMs

The “Big 3” PBMs are partly owned by large health insurance companies and they use their influence to steer drug utilization toward their preferred pharmacies. They also design their formularies to maximize rebates, which they keep, driving up costs for the end user while increasing their own revenues (insider tip: Google stock prices for these companies for eye-opening insight). As a result, employers and their employees bear the brunt of these escalating costs.

Many businesses don’t even realize they have options when it comes to selecting a PBM. But take it from us: Once a company moves away from the Big 3, they can enjoy transparent prices, significant cost savings, and a more straightforward approach to pharmacy benefits management.

Why SmithRx and Mark Cuban Cost Plus Drug Company Stand Out

SmithRx is a transparent, pass-through pharmacy benefits manager for self-insured employers, whose mission is to revolutionize pharmacy benefits by reducing complexity and medication costs. Mark Cuban’s Cost Plus Drug Company is a direct-to-consumer pharmacy dedicated to ensuring that every American has access to safe, affordable medicines at competitive prices.

By partnering with these companies we can offer our clients a more transparent and cost-effective solution for pharmacy benefits. This approach not only saves money for employers but also provides better outcomes for their employees and families.

The Financial Impact of Switching Away from the Big 3

Choosing to work with smaller, independent companies like SmithRx and Mark Cuban’s Cost Plus Drug Company can yield significant financial benefits. Employers gain access to detailed data on their prescription drug utilization and can receive rebates that are passed back to them rather than being kept by the PBMs. This transparency allows businesses to make more informed decisions and achieve cost savings that are passed on to employees.

Why We Stand Against the Big 3

At Snellings Walters, our commitment is to drive better results for our clients’ employees and their bottom line. The Big 3 PBMs are not conducive to this goal, which is why we actively work to help our clients transition away from them, and quickly at that. Our process focuses on minimizing disruption for employees while enabling more affordable prices for employers.

Continued reliance on the Big 3 PBMs perpetuates a system that prioritizes profit over patient care. As these companies continue to hike up drug prices, the burden on employers and the broader healthcare system increases. To combat this, we need more consultants and employers to challenge this new normal and explore alternative approaches.

Questions to Ask Your Benefits Advisor

If you’re concerned about your current pharmacy benefits arrangement, here are some key data-driven questions to ask your benefits advisor:

• What data drove your recommendation to place us with our current PBM?
• What rebates are we currently receiving for our RX utilization?
• What alternative PBMs should we explore as the market continues to evolve?
• How do we know this is still the best strategy for us?

You’ll likely find the answers to these questions both surprising and motivating. If you are self-funded, there’s no reason you shouldn’t have access to your data or the savings that are available through rebates.

At Snellings Walters, our partnership with SmithRx and Mark Cuban’s Cost Plus Drug Company is a reflection of our commitment to providing our clients with transparent, low-cost, and purpose-driven insurance plans. We believe in challenging the status quo and working toward a better future for employers and their employees. If you’re interested in learning more about how we can help you transition away from the Big 3 PBMs, contact us today to start the conversation.