PHARMAX

Pharmaceutical manufacturers offer assistance programs to help patients cover their out-of-pocket (OOP) cost on expensive medications. The programs however often circumvent the plans ability to drive utilization to preferred products and decrease consumerism by allowing members to reach their maximum out-of-pocket (MOOP) without any direct personal costs.

While these programs are helpful to the patient and the manufacturer, they often increase cost to the payer. There also is often unused funds available from the manufacturer as the program limit may be higher than the payer MOOP.

Pharmax enables clients to maximize funds available from pharmaceutical manufacturers to reduce plan spend and cover member OOP costs. Araya offers concierge service that tracks available manufacturer programs and assists members with the application and enrollment process. This allows the client to track OOP costs covered by the manufacturer program that currently may be applied to annual MOOP without the payer’s knowledge.

This program reduces client cost by increasing member copay to the amount available from the manufacturer. The increased copay is covered by the manufacturer cost while member OOP costs are unchanged and the cost to the payer is reduced.

Don’t miss out. Contract Araya and start taking advantage of existing programs.