The Edge

Clinical Account Executives are highly experienced pharmacists with diverse backgrounds in retail, infusion care and complex healthcare systems. Every CastiaRx client has one – and if you have not yet worked with your clinical account executive, now is a great time to make that connection.

With a deep understanding of cost drivers, these experts are able to recognize opportunities for savings and recommend steps to take control of costs. “We uncover hidden opportunities for our clients,” says Micah Howell, PharmD. “As clinical experts, we analyze plan metrics, provide guidance on plan design and market trends, and recommend solutions for improving plan performance.”

Most clients are interested in saving money with as little member disruption as possible. In January, as a new client came on board, Micah paved the way in the weeks prior, calling a subset of members to proactively talk about their medications, their new pharmacy plan and answering their questions. For the same client, he provided insight into cost savings that resulted in a decision to implement prior authorization for brand name medications for the treatment of ADHD and acne. With members trying generics first before more expensive, brand drugs, anticipated savings have been achieved.

“At times, we’re simply acting as an information resource,” Micah adds. “A broker recently called to talk about the potential of switching a specialty medication from the medical benefit to the pharmacy benefit. He was interested in how we would facilitate that change.”

Specialty, of course, is an area of growing client concern. “As a Diplomat company, we’re able to offer better solutions for clients financially and for their members clinically,” Micah concludes. “We’re more powerful today, with more ways of handling specialty medications.” If it’s time to fine-tune your plan, reduce specialty costs or drill down into specific drug classes that are driving your pharmacy trend, it’s time to meet with your clinical account executive. Contact your account manager to request a meeting.

Chances are, your plan members are looking for better ways to manage their pharmacy benefits. That’s why we created the CastiaRx Member Center – to make their lives easier!

“We find some members don’t realize the amount of information that’s available without calling,” says Katie Lettau, Marketing Manager. “We’ve put everything members need to know about their pharmacy benefits at their fingertips with the Member Center and mobile app.” To publicize and encourage registration, CastiaRx has launched an awareness campaign to plan members.

“We know satisfaction is higher when members have choices for working with their benefits,” Katie explains. “To encourage usage, and ultimately increase satisfaction, the email campaign includes a video to showcase the features that members really value.” Currently, the campaign reaches members with email addresses on file with us, which is a smaller number than you may think. However, we have several options for clients to utilize the campaign, to reach all their plan members.

“We are excited to spread the news about the Member Center and can tailor our approach so we reach more members via email,” Katie says. If you want to promote the Member Center to your population – and help increase member satisfaction – we can work with you to make that happen. Contact your account manager to assist in getting a tailored campaign underway.

Check out the campaign to learn more about the Member Center. And don’t miss our article below on the newest feature – the prescription cost estimator – which was launched last month.

High-cost, specialty drugs for the treatment of complex, chronic conditions represented just 13% of pharmacy spend 10 years ago. Today, that percentage is nearly 50%. With only 1-2% of your plan members driving these costs, it’s critical that this subset of your members receives outstanding care and support.

Powered by Diplomat, CastiaRx specialty patients now receive care from the largest independent specialty pharmacy in the nation. Diplomat treats thousands of patients each month and combines clinical expertise with a personal approach, helping patients adhere to therapy, avoid trips to the ER and hospital care, and build confidence as they manage their conditions.

What does this mean for our clients?

• 60% PA approval rating. You’ll know patients taking these special medications really need them.
• 94% medication adherence. You’ll know your patients are taking their medication as prescribed.
• 98% patient satisfaction. You’ll know your patients are getting the very best care.

“When payers let specialty patients receive therapy from any pharmacy, they miss out on the opportunity to help plan members receive consistent, high-quality care from the industry leader – not to mention the savings that come from an exclusive arrangement with us,” says Tom Hughes, VP of Business Intelligence. By making the move to exclusive specialty, a large Midwest employer saved 22%, or $1.9M, on specialty costs in 2018.

Designating CastiaRx as your exclusive pharmacy is easy to do, even in the middle of the plan year. By taking steps today to maximize outcomes and reduce costs, you will be better positioned to overcome the trend of rising specialty costs in the future. Talk to your account manager to learn more.

Our CastiaRx Specialty Additional Value (SAV) program is an essential resource to help you actively manage the cost of specialty drugs. With SAV, we help your members apply for any financial assistance offered by the specialty drug manufacturer. We then structure it so that the full amount, often as much as $12,000/year/drug, is used to bring down plan costs.

For a national employer with a January 2019 go-live date, specialty pharmacy costs were escalating out of control for their plan covering more than 4,000 lives. They were pleased to achieve the following 1Q savings after the implementation of exclusive specialty and SAV with CastiaRx:

• 48% decrease in specialty plan costs (YoY comparison to 1Q 2018).
• $200K+ in savings as a direct result of implementing the SAV program.

With SAV, the member’s responsibility for the specialty drug is reduced to $0, so cost savings are substantial for both the plan and your members – a true win-win.

Our unique Specialty Benefit Management approach landed us a spot on the prestigious Top 10 list of pharmacy solution providers. Chris Luthin, Group COO, shares his industry perspective and how we are helping clients manage their specialty pharmacy trend. Download the article.