Driving Value

Transformative Pass-Through Approach

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.

Like any PBM, we work with manufacturers and pharmacies to secure the best pricing, rebates and discounts possible on behalf of our clients. In a traditional arrangement, the PBM may take a spread and charge the client more than the pharmacy was paid. Or, the PBM may keep some of the rebate as a way to make money.

However, what makes us unique is our full pass-through model. We pass 100 percent of all discounts or rebates we receive directly back to the client, allowing us to take the unnecessary costs out of pharmacy spend. So with Navitus you can expect to:

Receive 100 percent of all discounts and rebates that we secure on your behalf
Get unrestricted visibility down to the claim and invoice level for better tracking and monitoring
Experience lower drug trend, decreased PMPM expenses and reduced costs

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.}

How Transparent is Your PBM?

Significant differences exist between a traditional PBM and a fully transparent pass-through model. Knowing the difference can help you save on pharmacy benefits. The key is in aligning your PBM’s goals with your goals. When they align, great things can happen. Here’s a quick look at the various PBM models and how they operate.

We cannot say enough positive things about transitioning our specialty pharmacy services to Lumicera. The Navitus account team had a high level of engagement prior to and post migration to ensure quality continuity of care. L.A. Care is delighted with the smooth transition and our members have provided extremely positive feedback. We know we are in good hands with Navitus and couldn’t be happier with our new specialty partner, Lumicera.

Yana Paulson

Chief Pharmacy Officer, L.A. Care

We wanted to partner with a PBM that is aligned with our requirement of transparency and disclosure. The Navitus business model is a great fit with true pass-through pricing, low net cost, superior customer service and proven experience to transition our membership with minimal impact.

Nick Kouklis

Chief Executive Officer, Self-Insured Schools of California (SISC)

Our holistic approach to well-being will always include solutions with innovative partners like Navitus that allow our staff to save money while enhancing their quality of life. The integration of pharmacy benefits and our other well-being solutions are key to our staff's success.

Elizabeth Rhoads

Benefits Manager, Compassion International

The financial savings we experienced have exceeded what we anticipated. Navitus has lived up to its promises.

Wendie Carlson

Chief Human Resources Officer, West Tennessee Healthcare

Why should I be concerned about spread?

If you’re working with a traditional PBM, chances are you’re paying too much. The reason? It’s spread. A PBM takes spread when it bills the client more than it paid the pharmacy. Unfortunately, this happens with rebates and in other areas, too. Here’s a look at the long list of traditional PBM pricing practices:

Retail spread
Mail-Order spread
Specialty pharmacy spread
MAC list spread
Rebate chasing
Hidden non-disclosed fees