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2023 DRUG TREND REPORT

Pass-Through Model Drives $160 Million in Savings

Texas Association of Counties logo-01

In search of a PBM partner that would manage their pharmacy benefit with flexibility and customization, Texas Association of Counties (TAC) chose to move from one of the largest pharmacy benefit managers to Navitus five years ago.

TAC was seeking a partner that would support custom benefit decisions with flexibility and data-driven insights. Since that time, Navitus has worked closely with TAC to manage their pharmacy spend and deliver exceptional support to their members.

The chart below illustrates TAC trend over time. Despite controlled but positive trend over the period, TAC still has lower PMPM than they did 5 years ago under their prior PBM.

5 year trend graph-01-4
 

Access to comprehensive data empowered TAC to make decisions that drove down costs. In the first year alone, TAC saw a net total cost per member per month (PMPM) of -28.8%.2 With our 100% pass-through model, clients benefit immediately from improvements to contracts with pharmacies and manufacturers, enabling them to receive the deepest possible savings throughout the life of their contract.

1The Use of Medicines in the U.S. 2023. www.iqvia.com. https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/the-use-of-medicines-in-the-us-2023
2Navitus internal data, including all programs.

5 year brian naisersnapshot--quote graphic top-01-1 In 2018, we made the decision to stop chasing rebates and manage to the lowest net cost, so we moved from a traditional spread arrangement to a 100% transparent contract with Navitus. That first year we reduced pharmacy costs by 28%, our Rx rebates were more than ever before, and 6 years later we continue to outperform pharmacy trend. snapshot--quote graphic bottom-01-1


— Brian Naiser

Financial Manager Health & Benefits Services, Texas Association of Counties

Download Your Free Copy of the 2023 Drug Trend Report Executive Summary

An in-depth analysis of trend, pipeline and GLP-1 management approaches
 
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Methodology

The Navitus drug trend is calculated by comparing the net total cost per member per month (PMPM) for 2023 to that for 2022. Net cost PMPM represents full-year (Q1-Q4) data for total member copays and plan paid amounts minus manufacturer rebates and fees. This value is divided by the total number of members and by 12 months of the year.

Net total cost PMPM trend consists of two components: utilization and cost and includes both specialty and non-specialty drugs. Utilization trend measures the change in total days of therapy. Cost trend measures the change in net total drug cost per the above. This analysis included data for more than 500 clients, representing 3M members within Navitus’ commercial book of business, including plan sponsors and health plans. To be included, these organizations must have been clients of Navitus in both 2022 and 2023. Exclusions from this analysis include products administered at physicians’ offices, clinics and hospitals, COVID-19 vaccines and supplies, weight loss products and any additional savings from copay assistance programs.