Pharmacy Benefits Management
Our modern, alternative solution leverages a powerful PBM engine built on a transformative pass-through approach, lowest net-cost philosophy and outstanding clinical model that works smarter and harder to deliver greater results. With this engine in place, ordinary PBM tools – such as utilization management, formulary, and networks – perform at a higher level to improve health more effectively and generate even more savings.
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100% Pass-Through
We pass 100% of all discounts or rebates we receive directly back to you. All of our revenue is based on a set admin fee.
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Lowest Net-Cost
While rebates and discounts are important, we focus on all factors to reduce overall cost, including formulary and drug mix.
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Clinical Care Model
Our patient-centered model works to improve health outcomes, which also improves long-term financial performance.
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Specialty Pharmacy
Our full-service specialty pharmacy, Lumicera Health Services, a subsidiary of Navitus, combines high-touch care and clinical support with a stringent cost management model. Our pharmacists and clinical experts provide a personalized approach to care, guiding members every step of the way to improve health and quality of life. Our unique acquisition cost-plus pricing model combined with first-in, first-out (FIFO) methodology, works to keep costs in check.
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Clinical Care Model
Our patient-centered model works to improve health outcomes, which also improves long-term financial performance.
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Cost Management
Strikes the right balance between high-touch support to meet your members’ needs and cost management to control expenses.
Learn moreThe Bottom Line
When you work with a fully transparent and pass through PBM the results are a given, but the experience is unique. Our expert advisors will lead you into a new adventure in pharmacy benefit management where you’ll get:
• A Clear View into your pharmacy benefit costs and savings opportunities
• The Guidance to get your benefit management going in the right direction
• Peace of mind that our expertise and experience are on your side every day
As a result, we make managing your Rx benefits feel less like work and more play. On top of that, our clients experience a substantial savings of 10-15%. We call it Pharmacy Benefits Reinvented.
Here are a few highlights of our results:
Navitus Results and Highlights
New Client Savings
Our pass-through model is so successful that in 2019, clients that switched to Navitus from another PBM saved 25%*, on average, in drug spend. Although these clients come from a wide range of industry sectors, by adopting our model and using recommend cost-reduction strategies, they achieved substantial PMPM trend savings.
*2019 Navitus data analysis (included clients who provided historical data).
Navitus Results and Highlights
Gross Profit Per Claim
We take the unnecessary costs out of pharmacy spend to ensure our clients receive all of the savings. All discounts and rebates are returned to the client. As you can see from this graph, traditional PBMs tend to keep a portion of the revenue for themselves. An agreed upon admin. fee is the only way that we earn money.
*Starting in 2019 this information is no longer available due to industry mergers of insurers and PBMs, making it harder to see how a PBM's revenue impacts your Rx benefit costs.
Navitus Results and Highlights
5-Year Cumulative Savings
Navitus clients experience lower than average PMPM. In fact, in 2019 we helped our commercial clients achieve a PMPM of $78.12, which is 16% lower than the forecasted* industry average of $93.11. But the savings aren’t limited to one year. Looking back over 5 years we held PMPM costs to a significantly lower number than the industry average, helping our clients save more.
*Forecasted trend increase based on data from the 2020 Economic Report from the Drug Channels Institute.
Who's Chosen Navitus Already?
We are the PBM of choice for government entities, self-funded employers, and associations. This includes health exchanges and organizations providing managed Medicaid and Medicare Part D.
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4.5 out of 5 Overall CMS STAR RATING
For our Medicare Employer Group Waiver Plan (EGWP)
2021
100% SATISFACTION
Survey results from clients post-implementation
2013-2020
