Actual Results #1

The following RxEDO client transitioned from a well known PBM with a traditional service model. The most intriguing aspect of these results is that our client realized these savings without making any changes to its previous benefit design or co-pay structure. Thus, there was no cost shift to the plan members. Additionally, although the client made no adjustments to the plan’s co-pays, the overall cost share for the plan improved by 2%; this was directly related to the fact that RxEDO’s billed cost for the drugs was considerably less than the previous PBM.

The following denotes key statistics based on actual claims experience:



Actual Results #2

The following RxEDO client transitioned from a well known PBM with a traditional service model. Like the previous case study, this client realized these savings without making any changes to its previous benefit design or co-pay structure. It is interesting to note that although generic utilization actually decreased after the transition, the total cost per claim improved by $8.27 per claim for the plan.

The following denotes key statistics based on actual claims experience:



Actual Results #3

The following RxEDO client transitioned from a well known PBM with a traditional service model. Prior to their transition this particular client looked to RxEDO for additional cost management strategies. The client acted on RxEDO’s recommendation to introduce a co-insurance copay for preferred/non-preferred (30%/50%) brand drugs thereby providing a consistent cost share for the plan and its members. Plan members paid the greater of $30/30% for preferred brand and $50/50% for non-preferred. Consequently, the co-pay change coupled with RxEDO’s PBP service model provided the following results:


Plan implemented a greater of co-insurance copay (30% -50%) to existing flat copay for preferred and non-preferred brand drugs.