Magellan Rx Medical Pharmacy Solutions Achieve $2 Billion Lifetime Savings

Magellan Rx Management announced that its medical pharmacy management programs achieved over $2.1 billion in combined, lifetime savings for current health plan customers enrolled in disease-specific programs. These programs are designed to mitigate rising medical pharmacy spend while maintaining a high quality of care for members. Health plan savings have continued to grow over the years, and 2018 alone generated nearly $415 million in savings for nearly 20 current customers.

Proven solutions to identify and mitigate trend of medical pharmacy costs

Medical pharmacy trend and spend presents a unique set of challenges when compared to traditional pharmacy management. Medical pharmacy drugs, which are used to treat high-cost, complex disease states such as oncology, autoimmune conditions, and rare diseases, are administered by healthcare professionals in a provider’s office, in a patient’s home via home infusion, or in a hospital outpatient facility. Magellan Rx has leveraged advanced analytics, digital technology, strong provider network collaboration, and a robust knowledge of trend to develop customized, flexible, and quality-focused solutions to manage medical pharmacy drugs. The savings delivered to health plan clients are generated from clinical efficiencies and interventions identified by specialized clinicians across several high-cost, complex disease states.

“We have collaborated with numerous health plans on these pioneering medical pharmacy programs that optimize appropriate use, clinical appropriateness and effectiveness, patient adherence, and cost management for this complex and rapidly-growing portion of specialty drug spend,” said Kristen Reimers, RPh, senior vice president, specialty clinical solutions, Magellan Rx Management. “Individual plans experienced overall savings of 10-15 percent depending on their population size and scope of implemented interventions, including prior authorization, post-service claim edits, provider network strategy, site of service management, and medical formulary management.”

Magellan Rx medical pharmacy solutions bring together innovative programs and services that enable health plan customers to identify appropriate therapy, promote clinical efficiencies, improve quality of care for members, and—when combined with a targeted benefit design—reduce member out-of-pocket costs while increasing access to more convenient care.

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