Prescription Management

Take Control of Your RX

The typical business will see pharmacy rise to account for 50% of their overall spending within the next 2-3 years.

Knowing this, Equinox has developed a number of pharmacy solutions that businesses can employ to keep this cost center under control. We’re able to deliver savings of 10-15% to clients who embrace a transparent pharmacy model and help them keep that money in their pocket.

               Medical Vs. RX Expense

What is a Prescription Carve-Out?

A prescription (RX) carve-out is when you remove the prescription plan for the carrier administering your health plan. You no longer would rely on their pharmacy plan but could customize your plan directly with a pharmacy benefit manager (PBM.)

Why would you do this?

Savings from RX carve-outs can be substantial. At a minimum you will be able to retain all of the prescription rebates you don't have today (typically worth 20% of your expense) and you'll be able to customize your formulary, network and utilization rules to contain your costs for the long term. Keep scrolling to learn more.

Pharmacy Utilization Consulting

Did you know that a 1% increase in generic usage equates to a 2% decrease in cost for a health plan? Are you aware that your plan is paying for access to pharmacies that will never be used? Do you have a communication strategy to help your employees making smarter medication decisions?

Sadly, most businesses are unable to answer these questions but Equinox provides solutions to all of these issues and much more. We start with helping you understand your pharmacy usage and then provide experienced insight as to how you can make the most of the plan you have in place today or we can advise on alternative options.

To get a better idea of how we help you do this, download our free prescription plan reporting sample to see if you are getting the data you need to control your spend moving forward.

Carve-Out Options

Pharmacy rebates account for 20% of your overall pharmacy cost on average but that money usually does not come back to your business. Most pharmacy plans also do not have the lowest generic discount rate applied which is more money lost for employers.

Equinox provides access to a pharmacy aggregating platform through our partner Confidio that provides for the highest amount of prescription discounts and rebates available. We pass all savings back to our clients so they retain the money that is rightfully theirs and keep their cost down.

Sample Analysis of RX Carve-Outs

Prescription carveout's make sense for most employers. The only true requirement is that you be self-funded or at least large enough for your fully insured carrier to allow you to carve-out your pharmacy. In order to show the potential savings, we have provided a few samples of carve-out savings below to give you a better idea.

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