$1 Million in Annual Pharmacy Spend Savings Identified Following Completion of PBM Contract Analysis

The Client

Retirement and Rehabilitation Facility with over 1,300 Employees and Dependents

The Challenge

The client experienced a large increase in pharmacy claims. As a self-funded group looking to mitigate costs, they felt stuck because they were locked in to their carrier under a ‘carve-in’ contract. The group sought competitive sourcing of this benefit from Caravus to help offset the $3.7 million they paid in pharmacy claims the previous year.

The Solution

The Caravus team identified hidden sources of revenue their Pharmacy Benefit Manager (PBM) embedded in the group’s contract. The sourcing project utilized a unique approach to the contract’s structure and pricing, which if implemented, would reduce costs with no change to the existing benefit plan’s design.

The Outcome

Under this newly proposed carve-out contract, the group would benefit from annual savings of approximately $1 million, saving the client 27% compared to the previous year’s pharmacy spend.