5653-0 ArrayRx-Booklet.pdf

Helping you get the best value for your pharmacy needs

Case studies

ArrayRx offers a comprehensive suite of pharmacy solutions. Our programs are developed for states, by states, to help organizations, employers and individuals get the best value while meeting their specific pharmacy needs.

The following case studies highlight some of the solutions ArrayRx offers our clients.

School Employee Pharmacy Benefit Program

Discount Card Program

Administrative Services Only Rebate Program

Prescription Drug Voucher Program

State Workers Compensation Program

School Employee Pharmacy Benefit Program

ArrayRx improves delivery of pharmacy benefits and drives down costs for state school employees

Challenge Organization: A state health care authority

Need: Improve the delivery of health insurance and pharmacy benefits for school districts and charter schools in the state.

Goal: Improve the affordability, transparency and equity of health insurance and pharmacy benefits, and consolidate collective bargaining for school employee benefits.

The health care authority was required to design and approve insurance benefit plans for all levels of employees working in over 300 school districts, educational service districts (ESDs) and charter schools statewide, and to be operational within three years. A key component of the request was to establish the state’s self-insured health plan as a benefit option for all schools and to ensure that pharmacy benefits could be administered across all participating entities.

Solution The state’s health plan selected ArrayRx to administer the pharmacy benefit program for its health plans. Working with administrators in the state’s health care authority, within 10 months, ArrayRx:

• Designed and configured four pharmacy benefit plans

• Developed customized formulary for four plans

• Created and tailored materials for and participated in 22 open enrollment fairs throughout the state

• Consolidated the transition from over 300 school districts, ESDs and charter schools

• Successfully transitioned and enrolled approximately 94,000 members into the state’s self-insured health plan

• Established data sharing with numerous vendors of state’s health care authority

ArrayRx was able to support the pharmacy benefit plans of the state’s school districts and charter schools since it:

• Contracts using a state-approved master participating program agreement that can be tailored to meet a state’s specific program needs

• Administers 100% pass-through pricing on pharmacy prescription drug claims and manufacturer rebates

• Delivers full program transparency and comprehensive audit rights

• Provides services via fixed administrative costs and multi-year fixed claims administrative fee

• Includes extensive reporting via a web portal

• Provides actuarial services in support of trend analyses and state Pharmaceutical and Therapeutics (P&T) rebate options

• Provides an annual market check conducted by a third-party to ensure pricing and contract terms remain competitive

• Other customizable services

Result The ArrayRx pharmacy benefit program for the state’s school employees helped the state consolidate and improve the delivery of health insurance and other benefits for school districts and charter schools in the state.

As a result, the most recent member satisfaction survey found that almost 87% of members surveyed were satisfied or very satisfied with the services provided by ArrayRx. The program continues to work with the state to keep costs down while managing appropriate drug use as part of effective treatment plans for its members.

Challenge Organization: A state legislature

Need: Find a way to extend the state’s pharmacy purchasing power to benefit state residents who needed help managing prescription medication costs.

Goal: Create a state-sponsored discount card that could be made available to any resident to help them save on prescription drug costs at the pharmacy.

The state legislature faced a critical challenge. Uninsured and underinsured residents faced high prescription drug costs that resulted in some residents declining crucial medications needed to manage their health conditions.

Solution The state leveraged the purchasing power of ArrayRx to create a state-sponsored discount card for state residents. The program allows state residents to benefit from the pharmacy network and financial discounts that are contracted for all programs that participate in ArrayRx.

This includes state partners that provide pharmacy solutions, including prescription discount cards, to public entities. The ArrayRx discount card program is available to any resident at no cost.

The discount card:

• Has no membership fees and there is no cost to join

• Extends the same contracted pricing available to public employees to any state resident

• Allows state residents to use the discount card at most pharmacies within the state and nationally

• Offers state residents discounts averaging 80% for generic and 20% for brand drugs, off of any FDA-approved and select over-the-counter medication at participating network pharmacies

• Provides an easy-to-use, online pharmacy locator and prescription drug pricing tools to help residents evaluate their pharmacy options

• Ensures that drug discounts preserve pharmacy access to residents in rural geographies

• Delivers detailed reporting, including monthly, semi-annual and annual summary utilization to the state

• Includes a minimal transaction fee for states at the point-of-sale to help offset state promotion and other costs

Result Using the ArrayRx discount card, the state was able to deliver savings for state residents estimated at over $5.3 million in the most recent three-year period. The ArrayRx discount card is the right choice for states seeking to help its residents save on their prescription drug costs.

Discount Card Program

ArrayRx saves state residents $5.3 million by lowering their prescription drug costs

Administrative Services Only Rebate Program

ArrayRx ASO rebate lowers prescription drug costs for public agency employees

Challenge Organization: A state public agency

Need: Seeking ways to better manage the costs associated with its pharmacy services.

Goal: Find a partner to work with to ensure it could secure manufacturer rebates for drugs on its preferred drug list.

While being directly responsible for providing medical and limited wage-replacement coverage to workers who suffer job-related injuries and illness and managing its prescription program, including the cost of drugs it covered, the agency was not benefiting from the availability of manufacturer rebates it qualifies for.

Solution The agency selected ArrayRx to administer its manufacturer drug rebate program.

ArrayRx was able to work with the agency to identify the covered drugs that would meet rebate criteria for contracts it had with manufacturers, or in some instances, where rebates could be improved using alternate rebate programs that ArrayRx could access. By being able to maximize eligibility for manufacturer rebates, the agency was able to lower the effective cost of providing prescription drug benefits to injured workers in its program.

ArrayRx created an Administrative Services Only (ASO) rebate agreement with the agency. As part of the agreement, approved claims by the agency could be reported to ArrayRx, along with the agency’s preferred drug list criteria, so ArrayRx could invoice manufacturers for medications eligible for the rebate. As rebate payments were received from the manufacturer, ArrayRx paid 100% of the collected amounts directly to the agency.

ArrayRx receives an administrative fee for this service, so all parties have complete transparency into the amounts billed, paid and received.

ArrayRx was selected because it:

• Offered the agency the flexibility to use its preferred drug list and criteria. Drugs that met a manufacturer’s criteria would be eligible for rebates.

• Delivered 100% of all rebates for eligible claims that were paid by manufacturers and passed through to the agency. No funds are held back or retained by ArrayRx.

• ASO rebate service complemented the agency’s coverage for injured workers helping to lower pharmacy costs

• Provided detailed claim-level rebate reports in the rebate disbursement reports that are available through ArrayRx’s client reporting portal, Moda Prescriptive Analytics

• Offered predictability by delivering the ASO rebate management program services that followed a published administrative fee schedule

Result The ArrayRx ASO-only rebate management program helps keep costs down. It does so by ensuring that eligible claims for manufacturer rebates are correctly identified, invoiced, collected and paid to public agencies responsible for providing outpatient pharmacy services for their covered members.

ArrayRx is the right choice for public agencies seeking a consultative approach to rebate administration that can lower the net cost for prescription medications.

Organization: A state correctional facility

Need: Seeking options to ensure that individuals can continue their prescription medication therapy after they are released.

Goal: Implement a solution that would ensure all individuals being released receive an adequate supply of medications for continuity of therapy to establish medical care in the community for future prescription refills.

The facility recognized that in order to ensure that incarcerated individuals can safely re-enter society, it is critical that they have no disruption to their therapy as they re-enter their communities.

Solution The ArrayRx Prescription Drug Voucher Program was adopted to provide incarcerated individuals with a drug voucher that could be presented at any participating pharmacy to have their medication refilled at no cost after they are released. Covered medications are paid for by the correctional facility at a discounted price that has been established by ArrayRx with participating pharmacies.

As an individual is ready to be released from the institution, the correctional facility enrolls them in the ArrayRx Prescription Drug Voucher Program through an online enrollment system. After their release, an authorized voucher is produced so they can receive a refill for their medication at any participating pharmacy in the ArrayRx pharmacy network. Facilities have the option to limit the voucher program to select medications by applying a unique formulary and/or maximum dollar threshold.

They can also limit the days’ supply dispensed, when refills are available, and the pharmacies where the voucher can be redeemed. ArrayRx processes all voucher claims and authorizes the dispensing and payment to the participating pharmacies before invoicing the correctional facility.

Savings on medications, including both brand name and generic medications, can range from 18% to over 80% off the pharmacy’s usual and customary price.

This can result in significant savings for the facility.

The state correctional facility selected the ArrayRx Prescription Drug Voucher Program because it:

• Enabled the facility to customize the voucher program to meet their specific program requirements and limitations

• Only invoiced the facility for what the pharmacy is paid (100% pass through) and guaranteed that all eligible manufacturer rebates are billed and paid

• Allowed them to limit the drugs that were eligible for the discharge program based on a maximum dollar threshold and/or days supply limitation

• Offered predictability by delivering the facility’s voucher services for a single fixed fee per claim

• Provided full program transparency and comprehensive audit rights

• Offered customized reporting to track voucher use

Result The ArrayRx Prescription Drug Voucher Program provides a solution for state facilities to preserve the state’s investment in an incarcerated individual’s health after they are released. Ensuring continuity of therapy helps ease the health care transition for incarcerated individuals as they return to their communities and seek ongoing care. It also helps reduce an individual’s relapse into crime.

Prescription Drug Voucher Program

ArrayRx ensures incarcerated individuals continue medication therapy after they are released

Organization: A state workers compensation program

Need: Seeking a pharmacy services provider to ensure that its insured workers had convenient access to pharmacies that could quickly determine and approve claims.

Goal: Find an innovative partner who could tailor pharmacy solutions to their specific needs. This included managing an extensive pharmacy network, providing transparent program operations, protecting against over-utilization and lowering prescription costs.

The state wanted to make sure that injured workers could quickly receive their required medications while ensuring patient safety and delivering positive outcomes were all a top priority.

Solution The workers compensation program implemented ArrayRx to manage the pharmacy benefit for its workers compensation beneficiaries. ArrayRx was selected because it:

• Offered flexibility to ensure the program could be tailored to meet the state’s unique program requirements

• Invoiced only for what the pharmacy is paid (100% pass through) and that all eligible manufacturer rebates are billed and paid

• Could implement and manage many custom formularies as defined by the state program to address unique needs

• Offered a proprietary first-fill program that allows injured workers to receive certain prescription drugs for work-related injuries or illnesses immediately following an injury and prior to a final decision on their claim

• Enabled the program to directly perform many functions typically performed by the PBM. These functions included adding and removing eligibility, making clinical determinations on drug coverage, controlling formulary selection and other responsibilities.

• Provided a pharmacy network that offered convenient pharmacy access for its injured workers

• Offered predictability by delivering administrative services for a single fixed-fee per claim

Result ArrayRx pharmacy solutions for workers compensation programs help keep costs down while managing appropriate drug use as part of effective treatment plans.

In the first 12 months with Array Rx, the workers compensation program saved approximately $1.2 million. By providing a consultative approach to pharmacy benefit design, ArrayRx is focused on meeting the specific needs of workers compensation programs.

ArrayRx is the right choice for workers compensation programs that want to manage their pharmacy benefits while getting injured workers the timely, effective, and appropriate care they need to recover.

State Workers Compensation Program

ArrayRx saves workers compensation program $1.2 million while ensuring workers have quick access to medications

To learn more, email info@ArrayRxSolutions.com or call 800-913-4146.

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