by Chris Van Hook
Pharmacy Consultant, Keenan & Associates
MABE decided to develop its own pharmacy program in collaboration with key stakeholders and pharmacy industry experts. We constructed a custom Pharmacy Benefit Manager (PBM) program called the MABE Pharmacy Purchasing Collaborative, co-managed with Keenan Pharmacy Services (KPS), an independent pharmacy benefit consultant with a proven track record with public schools and county governments in Maryland and across the U.S.
So how does our pharmacy program benefit people? MABE and KPS negotiate exclusive group purchase arrangements that provide deeply discounted pricing, and rigorous financial and service performance guarantees. Additionally, Keenan has negotiated a series of important services that enhances the client experience and provides real savings such as:
- Annual improvements in discounts;
- Payment of 100% rebates or the rebate minimum (whichever is greater);
- Ancillary programs at no-cost or lower cost than standard PBM fees;
- Dedicated customer service;
- Account management team; and
- An independent auditor that audits 100% of all patient claims, reporting quarterly to each client.
The MABE Pharmacy Purchasing Collaborative also includes a unique clinical management program with a group of industry-leading pharmacists and medical health experts that provides significant financial benefit to you and your members. This program focuses on savings for both specialty and non-specialty medications. Its specialty approach is unique in that we provide an independent prior authorization review of all specialty medications prior to them being dispensed. This review process uses custom clinical criteria and is completely independent of the PBM, which results in plan savings and more robust clinical effectiveness of the medications that are dispensed.
With specialty drug spend now exceeding 50% of the average employer’s total drug spend, it is crucial for a self-funded employer to have multiple options that provide lower-cost alternatives when an expensive specialty medication needs to be dispensed. To that end, the MABE Pharmacy Purchasing Collaborative offers a suite of clinical programs outside of the traditional PBM offerings to contain and reduce specialty spend.
What does all of this mean for county and schools in Maryland who self-fund their pharmacy benefit?
The programs offered by the MABE Pharmacy Purchasing Collaborative ensure that counties and schools have the confidence of knowing their pharmacy program is being managed by experts in the industry who have been working with these types of organizations for more than 50 years—we know your unique need of wanting a strong benefit program for your employees and their dependents, while taking a fiduciary-level approach to being good stewards of the county’s or school’s money.
Becoming part of a coalition program like MABE’s also allows your county or school to obtain deeply discounted pricing, rebates and guarantees typically available only to large health plans. We provide a more transparent program than what is typically offered in the Maryland marketplace by guaranteeing our discounts and 100% of manufacturer rebates – all of which are reviewed by an independent auditor who provides a financial assessment report that compares the plan’s performance to what is guaranteed in the contract.
The MABE Pharmacy Purchasing Collaborative is a real solution that will meet or exceed expectations via performance guarantees. Our independent clinical program will diligently manage your specialty drug spend to the lowest cost therapy for you and your members. What does this mean for you? It equals up to 30% of savings on your current drug spend. ESMEC, a current MABE collaborative member, has experienced $6 million in fully audited savings with this innovative program.
If you would like to further discuss the MABE Pharmacy Purchasing Collaborative and how it can help you control your pharmacy costs, please contact Chris Van Hook at Ph: (310) 749-6899.