COST PLUS SPECIALTY PHARMACY PROGRAM

Managing specialty costs and patient satisfaction can only be achieved when incentives between the payor the pharmacy and the PBM are aligned. The model used by the majority of the PBM industry today does not meet the requirements.

PBMs that own the specialty pharmacy can achieve a high level of patient satisfaction and compliance, but the opaque pricing model makes it difficult for the payor to determine cost effectiveness and simple for the PBM to conceal profits. PBMs with passive specialty pharmacy relationships may achieve a great level of cost control through aggressive contracting and utilization management programs but often experience lower levels of patient satisfaction due to a lack of coordination.

Araya’s cost plus specialty pharmacy program is built on the same principle as our pass-through transparent PBM model. Under this program the SP is paid their cost for the medication plus a dispensing fee that compensates them for the high level of clinical monitoring and oversight that the conditions treated with specialty medications require.

Araya’s relationship with our specialty partner goes beyond pricing. This close working relationship includes the SP clinical team in the development of our therapeutic protocols so they are not the result of a strictly administrative process but benefit from the real world patient experience that comes only from the direct patient contact experience of the SP staff.

The program aligns incentives by ensuring that the specialty pharmacy is compensated for the level of service without creating the incentive to dispense more or higher priced medications.

Take the guess work out of specialty drugs. Contact Araya for better pricing and better service.