By: Nic Hayes
When grocery shopping for your family, do you pay attention to the country where the meats, fruits, and vegetables you pick up come from? If you did, you would see that these food products are sourced from various countries all over the world. However, for these foods to be available on the shelves in your local grocery store, they first have to go through a strict approval process sanctioned by the Food and Drug Administration (FDA). With these food products littered throughout grocery stores in the U.S., most people don’t even give it a second thought when it comes to picking up their groceries, especially when those imported groceries may come at a lesser price.
While we’ve grown accustomed to purchasing food stuffs sourced from different countries, why haven’t we accepted a similar practice for our medications?
About 25 years ago, Bill Hepscher was looking for specific medications for his brother who was diagnosed with non-Hodgkin’s lymphoma. In looking for the medications, he soon realized that to pay for the treatments his brother needed they would be needing close to a half-million dollars. Through this process, he began to hear of more and more people who were travelling to different parts of Canada to get lower cost prescription medications. Driving to Canada wasn’t an option for Bill who was living in Florida, so he began to wonder how to provide wider access to these lower cost prescription medications, without having to travel.
Eventually, Bill’s experience led to him creating The Canadian Medstore to assist individuals with sourcing medications from outside the USA; then, after the introduction of the ACA RxManage was born providing an employer program for lower prescription drug costs to employers and their employees.
Why International
In the U.S. the federal government, Medicare specifically, has no ability to negotiate prescription drug costs even though it is the largest purchaser of healthcare in the entire world. Additionally, the Medicare Modernization Act made it illegal for Medicare to negotiate drug prices, so pricing is set to whatever price drug companies would like to charge.
Even though your plan members may not utilize Medicare, almost everything negotiated on a contract basis for a health plan is based on a Medicare allowable amount, so no matter the plan, drug manufacturers hold sole control of the price of their drugs.
Although this is the case in the U.S., in many other countries around the world the government purchasing authorities negotiate the price of medications directly with the manufacturer resulting in significantly cheaper medication prices.
International Sourcing
RxManage is not a pharmacy and does not actually dispense medications (they have contracted pharmacies that do the dispensing and shipping); instead, they serve as the administrator in the middle overseeing every step in the process to do with sourcing medications internationally. They have a pharmacist that manages the formulary, looking at every product to ensure it’s the same manufacturer and that there is no difference between the international and U.S. based product. RxManage sources specialty and brand name drugs internationally in order to bring savings both to employer sponsored health plans and individual plan members.
RxManage sources their medications from four countries: Canada, England, Australia, and New Zealand. These four countries are defined as tier one countries meaning that they have the same pharmaceutical quality control standards as we do here in the U.S. Additionally, all of these countries are also English speaking, so all labelling is in English making it easier for the plan member to feel comfortable with the medication.
While RxManage sources medications internationally, their overarching mission is to provide the lowest cost to the plan for prescription drugs, so they also monitor for when a generic version of a brand drug becomes available. Once this occurs it is typically cheaper for the member to get it locally, so RxManage will redirect them to do just that.
Increasing Access, Decreasing Cost
Through their program, RxManage brings significant value both to the plan and its members.
From an employer perspective, RxManage impacts the 10% of the population that drives 90% of plan costs, resulting in savings to the plan in the thousands or hundreds of thousands. Members also save with the internationally sourced medications made available at $0 co-pay, reducing the cost barrier for members to access their medications. For plan members this access is crucial because not having affordable access to prescription medications can lead to reduced compliance in taking their medications as prescribed or, even worse, not take them at all resulting in unimproved or worsened health conditions that could potentially lead to more health costs.
RxManage CEO and licensed pharmacist Casey Macpherson added, "Recent studies have found that 15-22% of Americans report not filling their prescriptions due to cost, predominantly for asymptomatic conditions such as high blood pressure, cholesterol or diabetes, all conditions with significant long term implications if left untreated. Providing these medications at $0 co-pay is of huge benefit to both the employer and the employee."
The RxManage program has significant value in increasing access to prescription medications for plan members while keeping costs down for both the plan and individual member.
We are proud to feature RxManage on the Granite List.