Jul 23, 2021 1:00:00 PM | 3 Min Read

Charting the Best Path to Pharmacy Benefit Savings

Charting the Best Path to Pharmacy Benefit Savings

Confidio’s Net Economic Value model provides a navigation system for selecting your PBM

With the arrival of summer and most of the population now vaccinated, millions of us around the country will be embarking on long-overdue vacations. Some of those trips will travel by air, and some by sea, but many will be by car in the form of a classic road trip. Charting the optimal driving route to your vacation destination can be rather complex. Your best result may not be the itinerary with the shortest distance. There are many other driving considerations, such as traffic patterns, road construction, and local speed limits, to name a few. Thankfully, our society has advanced beyond the days of relying solely on the colored highlighter lines drawn on enormous map booklets from AAA. We now have the luxury of cars and smartphones that provide GPS-enabled navigation systems and phone apps. Imagine the value of gaining the same type of insights while optimizing what route you pursue in selecting your PBM?

Taking a cue from our Smartphone travel apps, Confidio has launched the NEV or Net Economic Value model. The NEV model uses an innovative holistic approach to better assess true PBM value by looking beyond the fundamental elements of discounts and rebates. You can think of Confidio’s NEV as the GPS NAV system of your Pharmacy Benefits procurement. Identifying a means to measure the impact of the many economic drivers of a plan’s drug spend can be challenging. Confidio’s model tackles this issue head-on by leveraging data and analytics to incorporate each plan’s unique utilization alongside an evaluation of each PBM’s individual formulary and clinical programs. The impact of drug formulary strategy and utilization management design and execution can vary significantly across PBM’s. The traditional method of evaluating PBM partners based upon a spreadsheet exercise of repricing claims with proposed discounts and rebate guarantees provides an incomplete financial picture. This method does not fairly give credit for the value delivered by a PBM’s effectiveness at mitigating wasteful spending and driving toward lower-cost therapies which may not depend on large rebates.  

Much like Siri or Alexa suggesting an optimal route while you are behind the wheel, the NEV model approach will highlight the true economic value of a PBM offering that can only be achieved when taking a holistic assessment across multiple economic measures. As a plan sponsor or broker, the quest to find optimal value in your PBM relationship no longer needs to include unwelcome detours and costly toll roads. With the objective, transparent, and holistic insights of Confidio’s Net Economic Value modeling at your side, you will have a true roadmap for success.

Topics: Company News, Net Economic Value

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