Advair Diskus Inhaler is available as a generic, we have it in the pharmacy, and your insurance company is still requiring the brand. Here is why and what it is costing you….
Why- This is because some insurance companies receive incentives called rebates from manufacturer companies that produce the branded medication. Because they get this rebate and it goes right to the bottom line of their financial statement you the patient pays a higher copay and your employer foots the bill.
Doesn’t seem right does it? We though so too, but your pharmacy benefits manager job isn’t to lower cost, but to improve their profits. Just look at the quarterly earnings reports from Express Scripts, Optum RX or Caremark. When you start adding it up you have to ask where is the money coming from and where is it going.
Well the money is coming from the employers who pay for the Health Insurance, and the job of the PBM is to retain these dollars for shareholders.
As a small business owner it really bothers me that more pharmacies don’t offer direct to employer pricing for prescription drugs. Think about it as a small business owner, if i contracted with United healthcare I would be paying a premium just for my employees and myself to fill their prescriptions at my pharmacy at the rates dictated by the insurance companies for the medications I own. Why would I do that? Why wouldn’t I just negotiate with my employees to fill them at a rate that is fair to them, yet avoids the fees I would have to pay for health insurance and drug expenses paid to the pharmacy benefits manager. I can still pay for their benefit, but without the middleman fees. I could also decide if I want them to get a generic when its available like Advair in the example from above.
So we want to offer the same program to other small businesses. What if you could take your current healthcare expense and make it a fixed expense that would increase or decrease based on the number of employees you have instead of how long you have been with your current health insurance company.
For example, Caterpillar Company and the University of Michigan did this and it worked. Just Google it if you don’t believe it. If you want to add money to your bottom line or even save healthcare dollars for your employees call us at 314-962-1065.
By the way one employee switched from brand Advair to generic Advair could have saved $100 dollars per month or $1200 dollars per year. In the short term and probably more as the price of generic Advair comes down. But not if your health insurance company still requires the branded product.. So while your Health Insurance Company is pocketing rebate dollars, your still having to generate enough gross sales to cover $100 more per month in healthcare cost so your healthcare insurance group can make their quarterly earnings at your expense.
Finally, how much do you need to increase your top line sales to generate an additional $1200 in profit this year just to continue paying for that 1 inhaler.