Providing a global solution to combat rising healthcare costs

THE PROBLEM Prescription medications are routinely one of the largest cost drivers in every health plan. The U.S. outspends all other countries on healthcare, spending 3.23 trillion in 2015. Of this, 419.4 billion was attributable to prescription sales On average prescription drug costs are 44% higher in the U.S. than elsewhere in the world.

Are international pharmacy sources the answer to skyrocketing drug prices? Why are prescription drugs so expensive anyway? Its all Medicare’s fault… How did the international prescription drug industry come to be? Is it safe? Is it Legal? Strategies that brokers can use to lower the cost of prescription medication for groups, individuals and Medicare clients.

Skyrocketing drug prices. Its all Medicare’s fault… On July 30, 1965 President Lyndon B. Johnson made Medicare law by signing H.R. 6675 in Independence, Missouri. Former President Truman was issued the very first Medicare card during the ceremony. No prescription drug benefit was included

Medicare Prescription Drug, Improvement, and Modernization Act 2003. 40 years in the making Nixon-Watergate Carter-Recession, oil embargo Reagan-Iran Contra, Cold War Bush-Gulf War 80' and 90's Clinton-Some traction but was attached to President Clinton's failed health care reform proposal

2002 Republicans in charge of the White House and both Houses of Congress. Cost of prescription drugs becomes the number concern of American seniors. Unlike Clinton, the Bush Admin works with PHARMA and Health Insurers to facilitate Medicare Part D through private companies. Medicare Moderization Act makes it illegal for Medicare to negotiate drug prices.

International Rx is a factor in creating Part D Rx costs soar in the 80's and 90's "Bernie Bus Trips", AIDS epidemic, Dallas Buyers Club Internet

December 8, 2003 President George W December 8, 2003 President George W. Bush signs the Medicare Prescription Drug, Improvement and Modernization Act.

“Noninterference Clause” A bargaining chip used to attract market-oriented Republican votes was the so-called “noninterference clause”—a provision drug manufacturers had a major role in writing and getting through Congress—which banned negotiations between Medicare and pharmaceutical companies on drug prices.

THE SOLUTION Plan sponsors must be willing to look beyond U.S. borders for the acquisition of their members medications. Pharmaceutical Importation is a powerful tool in the effort to reduce healthcare costs. Up to 70% savings can be made on brand medication costs when sourced internationally.

Strategies for brokers

       

HOW? Rx Manage provides plan sponsors a program to reduce medication costs by offering plan members a voluntary mail order Rx benefit, through their network of licensed international pharmacies. Using the Rx Manage voluntary international program significantly reduces the impact of escalating drug prices. Rx Manage sources medications from licensed pharmacies in New Zealand, Australia, England and Canada.

BENEFITS 30-70% savings on brand medications No per member per month fees No administration costs Ongoing open enrollment Zero co-pay on traditional plans Transparent pricing

Advair Diskus 250/50 Average US price: $395 Average Medicare Co-pay: $65 Average International Price: $75

Going forward... Closing of the “donut hole”. Will provide more seamless coverage but it does not address Pricing. And is based on %. Lesser-known legal provisions originated in the MMA and were subsequently made law in theACA. This provision requires Part D drug plans to give access to all or nearly all drugs on the market in six protected classes. Originally intended to discourage drug plans from discriminating against patients with certain conditions, such as patients with HIV, this restriction has limited drug plans’ negotiating power. The pharmaceutical industry’s lobbying efforts topped $281 million last year; the industry has spent more on lobbying than any other industry since 1998...

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