Hylis Pharmacy Solutions seeks methods to control drug costs
Known as Hylis Pharmacy Solutions, the company provides self-insured plan sponsors with the actual cost of delivering pharmacy benefits to their members so that the costs of prescription drug programs can be controlled. Hylis can perform an analysis of a plan sponsor's prescription drug spending and determine what changes can be made to save money for both the sponsors and its members.
Pharmaceuticals are known to make up more than a quarter of a health plan's cost, with drug program costs doubling every eight to 10 years. This is the result of the inflation of branded drugs and happens despite the fact that many brands are available as generic versions.
To obtain better pricing for prescription drug programs, pharmacy benefit managers (PBMs) negotiate with pharmacies and engage in practices to reduce costs such as through managing drug formularies and promoting the use of generic drugs over brand names. However, there is often a lack of transparency in the financial transactions of PBMs that leads them to gaining profit at the expense of self-insured plan sponsors or health plans.
"While the industry is focused on savings, the complexity of the transactions and the lack of transparency make it difficult for plan sponsors to determine whether those savings are being maximized," Hylis Pharmacy Solutions CEO Greg Borca said. "With our knowledge and technology, Hylis Pharmacy Solutions can pull back the veil and deliver real insight to help most plan sponsors save anywhere from 15 to 25 percent on their costs. When you're talking tens or hundreds of millions of dollars in spend, that's significant."