Lower Mail Order RX Costs Through MedVantx

Since January 1, 2016 PPO Plan participants started to fill their prescriptions through the Navitus pricing network instead of Caremark. The main purpose of this transition was to make available to plan participants all necessary medication(s) while substantially lowering the Plan’s overall prescription drug costs. For the first three months the new program has delivered right in line with projections, albeit there have been some bumps in the road that had to be worked out within an average of over 2500 prescriptions being filled per month.

The most significant surprise has been both the service and pricing of MedVantx, the Plan’s new mail order service provider, as their turnaround and delivery service has been significantly better than was Caremark’s service and the pricing differential is extraordinary, even better than the pricing advantages of the new Retail 90 alternative through Navitus when compared to Caremark’s “Maintenance Choice” program.

Examples of the difference between a participant’s 20% co-pay for common 90 day generic supplies through MedVantx versus Caremark mail order are:

Omeprezole (90 days) $29.23 (11/15) $ 3.82 (2/16) -87%
Tamsulosin (90 days) $15.66 (8/15) $ 7.08 (2/16) -55%
Pravastatin (90 days/180 qty) $24.56 (12/15) $13.45 (3/16) -45%

With respect to service, between the day of placing the order through MedVantx to receiving it in the mail has been about 6-7 days where it was routinely 10-14 days through Caremark that pushed participants close to exhausting their supply of a medication.

If you are not using MedVantx, whereby medications are billed at actual cost plus a fixed handling fee, you are urged to call them at 1-866-744-0621 to get comparative pricing for your maintenance medications while keeping in mind that Retail 90 pricing at a particular pharmacy could be lower as of a particular day, but not as a rule. Their representatives will help you set up an account and move all of your maintenance prescriptions over to be filled when needed.

At the end of the day, where the cost of the very same prescription drugs are far lower than before through Caremark (retail, mail order or Retail 90) then both the participant and the Plan benefit, which helps to reduce the amount of future contribution rate increases to the members and contractors.

If you have any questions on using the new Navitus/MedVantx prescription drug programs please contact your claims examiner (x-702).

Taken from: Currents Issue 81 – May 2016