Overspending on EpiPen and Others

The EpiPen and its manufacturer Mylan have been getting a lot of bad press these days. Here’s why: according to The New York Times, "Mylan, the pharmaceutical company, acquired the decades-old product in 2007, when pharmacies paid less than $100 for a two-pen set, and has since been steadily raising the wholesale price. In 2009, a pharmacy paid $103.50 for a set. By July 2013 the price was up to $264.50, and it rose 75 percent to $461 by last May. This May the price spiked again to $608.61, according to data provided by Elsevier Clinical Solutions’ Gold Standard Drug Database.” 

These are huge price increases for the same old stuff. Sure, there are discounts and coupons so consumers won’t pay $600. But depending on the plan…your groups are footing the bill. And, EpiPen is far from the only villain. It's just the latest. They get away with it because the price is hidden in claims and competition (there are generic alternatives) is slim. 

You can help your customers fight back. 

For every single one of our customers, we find overspending on a long list of brand name drugs even though there are multiple generic alternatives available. Just one drug can account for tens and even hundreds of thousands of dollars wasted every year. Lipitor is a great example, and probably one that you may have already addressed with plan design. It's shocking how many new customers of ours are surprised to see they are paying for Lipitor AFTER they thought they addressed the issue with their Pharmacy Benefits carrier. 

We even see drugs with a generic and over-the-counter alternative still being paid for on your client’s Rx plan. A popular and egregious example is Nexium. 

Your customers are tired of seeing increases in their health care costs year after year. 

If you have insights into what they are actually paying for you can help them fight back. 

Are you using health data as a competitive edge?