In a recent government meeting, officials discussed a new program aimed at reducing prescription drug costs for employees, which could potentially save the county significant funds. The initiative focuses on sourcing medications through various assistance programs and international suppliers, offering a more cost-effective alternative to traditional pharmacy purchases.
The program, which will be rolled out during the upcoming open enrollment period starting January 1, 2025, utilizes two primary mechanisms for sourcing medications. The first involves accessing patient assistance programs (PAPs) and manufacturer programs, which can provide medications at no cost to participants. If this approach is unsuccessful, the program will then leverage international sourcing, obtaining medications from tier 1 countries at a fraction of the U.S. price—often between 20% to 50% less.
For example, the popular diabetes medication Ozempic, which costs between $1,200 and $1,500 per prescription in the U.S., can be sourced for approximately $333 in Canada. This significant price difference highlights the potential savings for both employees and the county.
The county anticipates a gross savings impact of around $222,000 over the past year from medications identified for the program. The sourcing company will take a 25% fee from the savings generated, ensuring that if no savings are realized, there will be no cost to the county.
Additionally, the program aims to alleviate financial pressure from high drug claims, particularly for employees with substantial medication expenses. By reducing these costs, the county hopes to improve its stop-loss insurance pricing, which is crucial for managing high claims.
Officials are seeking approval to implement this program, which they believe will not only benefit employees but also contribute to the county's overall financial health.