Forming Strategic Partnerships

Arxcel Works with Organizations Across the U.S.

If you are considering working with the Arxcel team to manage your pharmacy benefits, you may be asking yourself: who does Arxcel work with?

From manufacturers, to banks, to municipalities, our clients span all industries across the United States. For more details on some of our clients, read below to understand who we work with and how we've been able to help manage their pharmacy benefits programs.

The Inteq Group

Challenge

The Inteq Group, a pharmacy benefit manager located in Dallas, wanted to expand in the Northeast region of the United States. The group had a small sales force and needed the manpower to develop a client base in the new region while maintaining low overhead costs.

Strategy

We worked as a division of Inteq's sales force, contributing to their profitability by reducing travel, start-up and employment costs. We introduced Inteq to the Northeast market, creating a local presence that provided them with the exposure, perspective and industry insight to meet their expansion goals.

Results

Our work with Inteq resulted in increased exposure and numerous new clients. In only 18 months, we built the company's book of business by more than $3.6 million.

MDNY Healthcare

Challenge

MDNY Healthcare is a 75,000+ member, physician-owned HMO based on Long Island, New York. We began working with MDNY as the HMO's Pharmacy Director, organizing and driving the Pharmacy and Therapeutics Committee, overseeing pharmacy benefit management administration and providing insight on industry trends, plan design and clinical strategies.

Strategy

Using industry research and trend analyses, we developed a revamped plan design, designed and implemented streamlined policies and operational procedures, and conducted comprehensive data analysis to evaluate the success of the programs throughout the development process. Research revealed that shifting from a closed formulary to a three-tier benefit plan would allow members greater access to needed drugs and treatment options while still maintaining costs. Policies we initiated strengthened the relationship between MDNY and its pharmacy benefit manager and increased the quality of care and level of information given to providers.

Results

Total pharmacy costs increased by only 3.1% last year, compared to the national average of more than 15%. Through our comprehensive data analysis and audit, we were able to recover overpayments made by the pharmacy benefit manager. Our policy initiatives also laid the groundwork for NCQA accreditation. An evaluation of pharmacy benefit managers resulted in over $1.5 million in administrative cost savings for MDNY. In addition, the move to the new prescription benefit manager complimented the clinical and physician initiatives. These factors have allowed MDNY to continue staying ahead of national drug trends.

VitaRx

Challenge

VitaRx National Mail Order Pharmacy, a fledgling mail service pharmacy, wanted to break into the industry nationwide. The mail service pharmacy industry was, by many standards, a hyper-mature market dominated by a select few companies with little room for other contenders. Gaining recognition and clients was to be a daunting challenge.

Strategy

We were brought in to advise VitaRx from the ground up, developing a full product line to differentiate the pharmacy from the competition, from identifying and purchasing the mail service facility to hiring and training all staff. We designed the organizational structure of the company and handled all operational positioning. Working with their communication consultancy, we developed their corporate identity, promotional materials, Web site and community involvement. We also served as their sales force, helping them to build their client base while developing strategic alliances with managed care organizations across the country.

Results

Within 15 months of helping to conceive and launch the business, we were responsible for monthly sales revenue of some $2.5 million for VitaRx. In fact, despite a clear and dominant market leader, we were able to help this new company capture the significant majority of the market share in the Southeast region in which they launched, and two of the largest managed care organizations in the nation became VitaRx clients.

Northwest Savings Bank

Challenge

The Northwest Savings Bank offered its some 600 employees prescription drug benefits through the company-sponsored health plan. At the time, employees paid for their prescriptions in full and then submitted the claim for reimbursement. The third party administrator (TPA) processed the claim in accordance to the insurance plan's deductibles and co-payments. When Northwest implemented an across-the-board acquisition and retention program, the bank decided to enhance the prescription benefit program through a prescription drug card as a means to attract and retain key employees while staying within its budget.

We pointed out some important considerations, including:

• Prescription drug card programs can result in an increased amount of prescription benefit claims

• The existing health plan design minimized the overall exposure to drug claims

• The medical claim system in place provided only dollar amounts—there was not enough detail to make accurate claim projections

Strategy

We conducted extensive research and reviewed Northwest's drug data and gross medical claim information from the past 24 months. We also worked with Northwest to gain a complete understanding of their goals and objectives, as well as to address their concerns, which were primarily:

To maintain costs at a reasonable level
To increase employee satisfaction with the overall benefit program
Ease of communication with multiple locations (more than 25) in rural communities
Minimal administrative hassles

We prepared financial models and plan design alternatives, projecting costs both under the current program and under the plan alternatives.

Based on our research, we provided the client with two possible options:

A prescription drug discount card, providing discounted prices, drug utilization review and strong data. This option would work just like a traditional card program except that the employee would pay 100% of the discounted price. Claims would still be submitted to the TPA for reimbursement. This option was appealing because of its ability to gather data for the purpose of projecting drug costs and trends for Northwest.
A prescription drug card program, with a co-payment and plan design that included controls on days' supply and limitations for certain products (e.g. Viagra or Imitrex). This option also included a physician-oriented utilization program that offered assistance in selecting the most cost-efficient yet effective products for the employees. We did not recommend any punitive programs such as a closed formulary or mandatory generic program.

Both of these recommendations came with cost projections and an evaluation of the potential impact on the employees' perception of the company, employee communication and administrative requirements.

Results

Northwest chose the second option. We worked with them to implement the program over a 60-day period that allowed for effective communication with employees, coordination with the TPA and a custom-designed prescription ID card.

Costs increased by only 8% during the first 15 months—less than half of the standard industry cost increases rates. Northwest Savings Bank increased its number of employees by 50% during this period, and they equate a portion of their excellent employee relations with the introduction of the new prescription plan. In addition, the human resources department received nearly a dozen complimentary letters about the plan from employees, and the TPA has reduced administrative tasks by removing prescription claims processing from their workload.