We’ve spent some time talking before about how legislation is developing to challenge out-of-control pharmaceutical pricing.

Developing that legislation is likely to be one of the key bipartisan meeting places at a time where one party holds the Senate majority and another holds the House. 

20-25% of most employers’ healthcare expenditures go to pharmaceuticals. As we’ve explained in the past, part of this is due to PBMs (Pharmacy Benefit Managers) incentivizing higher drug spends.

An oft-cited case study for this problem are diabetes treatments like Metformin and insulin. The price of insulin has more than doubled within five years — and many professionals believe that PBMs are to blame.

When it comes to insulin, the price point can be a matter of life and death. More and more stories are emerging about diabetic patients turning to black market sources or else attempting to ration their insulin, which often results in death.

Metformin, another primary treatment for blood sugar in diabetics, has also seen a dramatic increase. 

This obviously dire situation has quickly attracted the attention of lawmakers, who aim to prevent manufacturers and PBMs from continuing to drive up the prices. But for health benefit providers who are trying to cover the cost of their members’ vital prescriptions now, the legislative process can feel dangerously slow.

What can you do to protect your employees from those kinds of harrowing choices? Captiva and other companies adhering to the Health Rosetta are working to do exactly that by holding their partners accountable to a standard of transparency.

This model works by only partnering with PBMs who are willing to allow full access to the pricing data, accepting that purchasers have the freedom to use that data to shop around for the best possible prices. Better PBM contracts have been proven to reduce pharmaceutical spends by 5-10%.

Captiva partners with you in the process, helping you assess the available information in order to find the best possible price.

Captiva also assists in helping you understand and navigate the many moving parts of the pharmaceutical industry and PBMs, demystifying a notoriously opaque system. Understanding the forces that are driving drug prices up helps you circumvent the system — and pass those savings on to your employees in the form of life-saving necessities.

If you’re ready to find out more about how we can push back against the skyrocketing pharmaceutical prices together, give us a call.