Not unlike the big, red spot on the surface of Jupiter, the tempest known as health-care reform rages on, seemingly mired in place.
RxResults, a Little Rock firm that manages and supplements pharmacy benefit management services for large, self-insured employers, is trying to provide a little shelter from the storm through an innovative, evidence-based approach to prescription drugs.
But let’s be clear – RxResults is not a pharmacy benefit manager (PBM).
"Rather, RxResults is an advocate for the employer and its employees — the payers — that enhances the clinical component of the PBM service offering," said Chris Monroe, the firm’s national sales director.
In essence, RxResults is implementing its own version of health-care reform.
RxResults is an Innovate Arkansas startup company that came out of the University of Arkansas at Medical Sciences BioVentures business incubator and has grown from pitching an idea to impacting the bottom line of some major employers and their employees. RxResults now boasts 19 clients in four states — Arkansas, Texas, Michigan and North Carolina — with three more clients set to come on board in January.
"When we started, a couple of years ago, all we were selling was a proof of concept, a model," Monroe said. "Fortunately, we were able to get a couple of people signed up and can now offer other prospective employers a solution that has produced proven, tangible results."
Those "couple of people" provided word-of-mouth advertising and testimonials that have helped RxResults go national. Its client list now includes the Texas Municipal League; North Carolina Municipal League; Muskegon County, Michigan, as well as the Arkansas Municipal League and Arkansas Employers Health Coalition. RxResults is currently working on several other client relationships including the University of Texas System, the Missouri High Risk Health Insurance Pool and the Clovis School District in Clovis, Calif.
Indeed, the momentum created by those first sales and the clients’ results that followed enabled RxResults to extend its reach. A 15-30 percent drop on average in members’ prescription drug costs can do that for you. Plus, Monroe noted a new partnership with Human Factor Analytics of Russellville that he said will give RxResults the chance to blend its pharmacy model into HFA’s broader health-care risk management solution, "to the benefit of many employers across the country."
The secret sauce that enables large, self-funded employers to realize prescription drug savings is the evidence-based prescription drug program (EBRx) developed at the UAMS College of Pharmacy. Essentially, this comprehensive research model analyzes clinical and economic differences between drug choices and, in turn, helps employers and their employees make drug choices based exclusively on clinical evidence.
"By doing so, this evidence-based formulary will steer employees to a clinically equivalent, therapeutic alternate generic therapy which will also lower the member’s out of pocket expense based on a lower, generic co-pay rate," Monroe said.
The formula appears to be working. UAMS has applied its EBRx system to the Arkansas Medicaid program and the Arkansas State Employee Benefits Division, together accounting for more than 700,000 members, since 2004. The success of the program with Arkansas state agencies provided the spark that spawned RxResults to commercialize this model and to market and sell this innovative approach beyond the state’s borders.
Leonard Martin, city manager for the city of Carrollton, Texas, said he first became aware of RxResults through his role as chair of the Public Employee Benefits Alliance, an organization of local Texas governments created to develop cost-effective, health-care solutions for its members.
The alliance asked RxResults to analyze its members’ prescription drug usage for the previous year. The results were good. So good, in fact, that the alliance launched the Rx Results system on Jan. 1 of this year.
Based on the initial evaluation, Martin said his group of over 700 employees could have realized savings of more than $300,000 by implementing the RxResults model. He cited other benefits:
- Steering employees and dependents to use effective alternative drug treatments that are effective for 80-plus percent of patients.
- Employees can use the drug of their choice.
- If they choose a more expensive drug they pay a higher co-pay for each refill. But if they use the RxResults alternative, the prescription can, in some cases, be free to the patient.
Martin said his group will save more than $340,000 this year (a reduction of 25 percent of their previous annual prescription costs) using the RxResults model. In fact, his own switch from Lipitor to (RxResults-recommended) Simvastatin, he said, will save him hundreds of dollars per year in co-pays.
"I am a strong supporter of RxResults because I have personally observed the benefits it brings to reducing health-care costs without diminishing the quality," he said. "I have recommended the program to several other cities as well as used it as an example in presentations on controlling health-care costs I have done for various organizations.
Another true believer is Susan Smith, executive director of the Texas Municipal League’s Intergovernmental Employee Benefits Pool. She said the benefits of the RxResults program extend beyond saving money.
"This program did realize cost savings, but more important, the consumers are becoming educated and we are now moving our membership into a ‘being in charge of your health’ campaign," she said.
Rx Results CEO and founder Tery Baskin said his firm has run costs-savings analyses for 130 companies and organizations. So far, RxResults is 130-0 in realizing would-be cost savings.
"This is a new model," Baskin said. "This, really, is health-care reform."