In the News
Madison-based Navitus, with Costco as part owner, expands its drug benefit business
- Wisconsin State Journal
With nearly 1,000 employees and new partial ownership by Costco, Madison-based Navitus Health Solutions is growing in a pharmacy benefits industry dominated by a few companies whose opaque practices have led to transparency laws, including one adopted this year in Wisconsin.
Costco Brings Its Low-Price Magic to Employer-Paid Drug Plans
- Bloomberg Businessweek
Pharmacy benefit managers typically make money by taking a cut of the drug price savings they negotiate for employers. Navitus says its fee-only model avoids financial conflicts.
Building relationships for better health: 3 patient interventions to improve adherence
- Drug Store News
The financial and health implications of medication nonadherence are staggering — costing the U.S. healthcare system between $100 and $290 billion annually and taking the lives of 125,000 people each year. When patients fail to take their medications as directed, they are at risk of disrupted treatment, disease progression, increased hospitalizations and unnecessary medical costs.
4 FAQs (and answers) employers may have about COVID vaccinations
Employers should be prepared to communicate their organization’s point of view on any vaccine requirements, says Brent Eberle.
How to achieve a drug formulary that reduces costs and maintains access to care
Wasteful drugs could be driving up your pharmacy benefits spend–here’s how to evaluate, identify and establish a high-performance formulary.
The Journey to Improve Population Health
- DiscoveRx Magazine
Through managed care pharmacy, [University of Wisconsin-Madison School of Pharmacy] alumna Eileen Murphy improves outcomes for Medicare patients.
Navitus: a 'Full Pass-Through' PBM Working to Improve Medication Adherence
- Tuning in to the C-Suite: an MHE Podcast
MHE Associate Editor Briana Contreras and Senior Editor Peter Wehrwein speak with Julie Olson, senior director of Population Health and Product Development at Navitus, a full pass-through pharmacy benefits management (PBM) company.
Pharma benefits in 2021: 4 trends to watch
While organizations will continue to invest in PBM partners to achieve cost savings, a few key areas will drive significant impact in 2021.
Top Drug Approvals and Product Launches of 2020
- Drug Topics
A look back at the most impressive drug approvals and product launches of the year.
Opioid overdoses are spiking amid the pandemic - PBMs can help combat opioid abuse and misuse
- MedCity News
Opioid overutilization is a public health crisis, and PBMs with programs aimed at curbing abuse and educating providers can have a positive and substantial impact on clients and their members.
In Land of Giants, Smaller PBMs Find a Niche
- Managed Healthcare Executive
In the consolidated PBM industry, smaller companies say they can be nimble and not driven by rebates. But are they acquisition targets?
3 strategies to promote the value of medication adherence among plan members
As the pandemic creates lasting effects on our economy and health care system, the major barriers to medication adherence have worsened.
A Look at the Year in Generics
- Drug Topics
The generic pipeline continues to provide significant value to payers and patients as key products in top therapeutic classes lose patent protection.
Maintaining affordable access to prescriptions in a post-pandemic world
- MedCity News
As the Covid-19 pandemic continues to evolve, pharmacy networks have largely delivered against the challenge to meet critical health care needs. Pharmacies across the country remain open to accommodate patients, and anticipated drug shortages and supply chain concerns from early in the pandemic have not come to fruition.
Navitus Achieves Double-Digit Savings for New Clients in 2019
- RADAR on Drug Benefits
Navitus Health Solutions, a PBM that touts a 100% rebate pass-through model and a lowest-net-cost formulary, says it is seeing success in moderating total net cost per-member per-month (PMPM), particularly for new clients.
The company’s 2019 Drug Trend report, released in May, said Navitus achieved an “industry-leading” total net cost PMPM of $78.12 across its commercial business, 16% lower than the forecasted industry average of $93.11 PMPM.
3 considerations for selecting a truly transparent pharmacy benefits partner
While the word “transparency” is commonly used across the PBM industry, the reality is that not all transparency is created equal.
PQA Presents Quality Awards to 24 Medicare Plan Contracts for High Achievement in Medication Quality
- Pharmacy Quality Alliance
The Pharmacy Quality Alliance (PQA) has recognized 24 Medicare plan contracts with a quality award for high achievement or significant improvement in PQA measures of medication safety and appropriate use. The awards are based on published CMS Medicare Part D Star Ratings.
Navitus MedicareRx is recognized with an Excellence in Quality Award for PDPs and Dean Health Plan is recognized with an Excellence in Quality Award for MAPDs.
With Costco Now in its Corner, PBM Navitus Thinks Big
- RADAR on Drug Benefits
Serving just 6.2 million members, Navitus Health Solutions — a PBM owned by St. Louis, Mo.-based integrated health system SSM Health — is hardly one of the industry’s major players. But given that it features a “pass-through” business model in an era when opaque PBM structures are facing scrutiny, and Costco Wholesale Corp. recently purchased a minority stake in the firm, Navitus may be poised for a bigger spotlight.
NW Prescription Drug Consortium announces Moda and Navitus as contractors for their pharmacy benefit
- Oregon Health Authority
The NW Prescription Drug Consortium is pleased to retain Moda as their contracted program administrator and begin using Navitus as their pharmacy benefit manager (PBM) effective January 1, 2022.
Business Group Achieves First-Year Pharmacy Savings
- Milwaukee Business Journal
Employer costs for pharmacy benefits are continuing to increase partly due to the costs of specialty medications, said Jeff Kluever, executive director of the Business Health Care Group. Pharmacy benefit managers, which are third-party administrators of prescription drug programs for insurers, say they reduce those costs but Navitus takes it further by passing along to employers all rebates and discounts.
The Slow Reveal
- Managed Care Magazine
Rebates have created pay-to-play dynamics. Employers facing high drug costs have “rebate addiction.” And the impressive “rebate guarantees” are hard to resist. But at least the process of how drugs get formulary placement is becoming clearer, and some PBMs have moved to charging administrative fees only.
Small PBMs Urge Congress: Don't Kill Rebates
- Healthcare Dive
Smaller pharmacy benefit management companies, rarely in the spotlight, are urging Congress not to fundamentally alter the way prescription drugs are paid for in the U.S. As the Trump administration advocates banning rebates under Medicare and Medicaid, these lower-profile PBMs aim to convince lawmakers not to junk the entire system. They say Congress should start by examining business models other than just of the nation's largest PBM players.
Policy Makers Seek Answers for High Costs of Prescription Drugs
- Pharmacy Times
Members of Congress sought to deconstruct the drug supply chain Thursday in an effort to find ways to lower prescription drug prices. Hosted by the House Committee on Energy & Commerce, the investigational hearing drew testimony from health care industry experts representing drug companies, insurers, and patient advocacy groups.
PBM executive: Industry has been discussing end of rebates for a 'long, long time'
Though the Trump administration’s steps to end drug rebates have been met with outrage from pharmacy benefit managers (PBMs), these companies have been talking about a future without rebates for a long time, experts say.
Wisconsin Pharmacy Benefits Combination Challenges National Giants
- Milwaukee Business Journal
A “significant number” of southeast Wisconsin employers are in the pipeline to enroll in a new local pharmacy benefits program that promises savings and a departure from the much-maligned large national pharmacy benefits firms.
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