De-Mystifying Rebates: The Crumdale Solution
Prescription drug spend is expected to continue to increase at a rate of 6.1% per year from 2020-2027 Centers of Medicaid and Medicare (CMS) reports. A large driver of this is due to the approval of new novel orphan drugs like Zolgensma, the first gene therapy approved to treat children with spinal muscular atrophy (SMA). This breakthrough therapy comes with a shocking price tag of $2.1 million. With orphan medications being approved at a much more frequent rate, it is critical for employers to find ways to control cost where they can.
Crumdale Partners utilizes numerous innovative cost containment levers to reign in pharmacy spend for our broker/employer partners. One area of focus that has gain national attention over the last year is PBM rebates. We have found that employer groups often leave potentially millions of dollars on the table.
The PBM rebate system can be a very complex and confusing system. In the diagram below see how Crumdale leverages fortune 100 PBM contract rates and terms to ensure 100% of rebates are passed on to our employers.