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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 2017, clients that switched to Navitus from another PBM saved 17 percent, on average, in drug cost. 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.

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.

Navitus Results and Highlights

5-Year Cumulative Savings

Navitus clients experience lower than average PMPM. In fact, in 2017 we helped our commercial clients achieve a PMPM of $76.56, which is 15.5 percent lower than the industry average of $90.66. 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.

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.

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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 extrememly positive feedback. We know we are in good hands with Navitus and couldn’t be happier with our new specialty partner, Lumicera.

Yana Paulson

Senior Director, Pharmacy, 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

Consultants & plan sponsors: Have a question?

Members: Please call the number on back of your ID card. Clients: Contact your client services rep.