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Navitus Health Solutions 2019 Annual Drug Trend Report Reveals Industry-Leading Cost-Cutting Results

  • May 18, 2020
  • PBM Model
MADISON, Wis., May 18, 2020 -- Navitus Health Solutions, a full pass-through pharmacy benefits management (PBM) company, released its 2019 Annual Drug Trend Report today, demonstrating that it continues to provide substantially lower costs, guidance and peace of mind for its clients. Achieving an industry-leading total net cost per member per month (PMPM) of $78.12 across its commercial business, Navitus provided savings 16% lower than the forecasted industry average of $93.11 PMPM.

As rising pharmacy benefit costs and increased utilization continue to cause concern among plan sponsors, Navitus, a full pass-through PBM has once again demonstrated its ability to provide substantially lower costs for its clients. In fact, Navitus’ 2019 Annual Drug Trend Report shows that clients who moved to Navitus from another PBM in 2019 saved an average of 25% in drug spend.

“With our commitment to make pharmacy benefits more affordable for everyone, this achievement allows us to deliver improvements in PMPM costs for many of our plan sponsors,” said Navitus’ Tom Pabich, SVP of Business Development and Client Services. “In fact, 40% of our clients experienced a negative PMPM trend compared to the previous year. Our transformative, pass-through approach has allowed us to put every dollar we receive from discounts or rebates back into the plan sponsor’s hands — which is exactly where it belongs.”

In addition to lowering costs, additional highlights from the report reveal that Navitus:
  • Generated client savings of between 3-5% off retail drug spend using a narrow network management option, with some saving as much as 10%.
  • Helped up to 40% of identified members meet their goals for improvement after intervention through Navitus’ Retrospective Drug Utilization Review (RDUR) safety program.
  • Saved plan sponsors an average of 8% on specialty medications purchased prior to inflationary price increases in 2019 with our first-in-first-out (FIFO) specialty pricing.
  • Improved condition target levels for 28% of members with asthma and 21% of members with chronic obstructive pulmonary disease (COPD) via Navitus’ Respiratory Health program.
  • Achieved an average adherence rate of 91% (based on the proportion of days covered) through a specialty pharmacy program for conditions such as hepatitis C, rheumatoid arthritis, multiple sclerosis and more.
The report also shows that the top 10 drug categories continued to grow as trend drivers in 2019, accounting for 68% of overall costs. This is up from 61% in the previous year. The top trend drivers were dominated by medications used to treat autoimmune diseases (anti-inflammatory and dermatological categories), diabetes, cancer, multiple sclerosis and HIV/hepatitis C (anti-virals).

Utilization for non-specialty medication, also known as maintenance medications for chronic conditions (e.g., diabetes, asthma, hypertension, etc.), was up about 3%, suggesting improved member adherence.

Utilization of migraine products, anti-psychotics, anti-depressants and anti-diabetics increased by more than 5%.

Non-maintenance medication utilization was nearly flat, and opioid utilization continued to decrease, dropping 16.5% from the previous year. Specialty utilization continued to increase, rising 14.7%. The top four specialty drug categories, including anti-inflammatory analgesics, anti-neoplastics and adjunctive therapies, multiple sclerosis agents and dermatologicals, accounted for 66% of specialty spend.

“Despite these metrics, Navitus achieved industry-leading results,” said Navitus SVP, Health Strategies and Chief Pharmacy Officer Brent Eberle. “We’ve continued to leverage and expand our transformative pass-through approach to deliver a lowest-net-cost formulary and member-centric clinical care model. With this system in place, our utilization, formulary and network management continue to perform at a higher level, resulting in improved health and even more savings.”

Download a copy of the Navitus Health Solutions 2019 Annual Drug Trend Report here.

About Navitus
Navitus Health Solutions is owned by SSM Health and Costco Wholesale Corporation and serves as a full pass-through pharmacy benefit manager (PBM) and industry alternative to traditional models. As such, Navitus is committed to taking the unnecessary costs out of pharmacy benefits to make prescriptions more affordable for its over 650 plan sponsors (e.g., employers, health plans, unions, governments, etc.) and their 6.2 million members. By combining a unique pass-through approach that returns 100% of rebates and discounts with a focus on lowest-net-cost medications and comprehensive clinical care programs, Navitus helps reduce costs and improve member health. To learn more about Navitus, call (877) 571-7500 or visit

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