How to gain from smart Pharmacy Plan Design

We design structures to steer users to the most cost effective treatments.

  • We pay pharmacies more for filling scripts in a cost effective manner.
  • We change consumer patterns through useful education and helpful consultation:
    • Semi– annual comprehensive benefit statements.
    • Targeted communications educating members on options and alternatives.
    • Targeted incentives to encourage making cost effective decisions.
    • Follow-up letters when consumers make less cost effective decisions.
    • Follow-up with pharmacies that have less effective patterns.
  • We manage inappropriate utilization by challenging users who choose to use less cost effective treatments.
  • We provide more and better information on patients and prescriptions.
  • We give users incentives for filling prescriptions at pharmacies that add value and lower cost.