For employers looking for simple solutions to eliminate wasteful spending while ensuring members get the care they need, tackling medical specialty drugs is a great place to start. As much as 40% or more of an employer's specialty drug spend sits under the medical benefit, including some of the most expensive medications like oncology and gene therapies. For many plans, limited management of these medications leads to significant waste - additional spend that does not yield additional clinical benefit. Archimedes' MEDiQ program is a proven solution to help employers address the challenges of managing medical specialty drugs. The case study below shows the experience of an 80K life employer whose spend remains 49% lower three years after implementing the program, spending $4.5M LESS in 2023 than they did in 2020. Contact us to learn how MEDiQ can help your plan take control of your medical specialty spend. #SpecialtyDrugManagement #HealthcareInnovation
Archimedes
Hospitals and Health Care
Brentwood, Tennessee 4,233 followers
Discover a better way to manage specialty drugs.
About us
Specialty drug spend is the single fastest growing healthcare expense. Recognizing the potential clinical value of these drugs, plan sponsors want to provide them to their enrollees—but to maintain an affordable, sustainable benefit in this rapidly changing environment, they must also control costs. To do this, plan sponsors need quantitative information about which strategies work to target drugs to those in need of them and they must minimize use of clinically ineffective therapies and reduce waste. However, the guidance and services provided to plan sponsors to achieve these goals is not always objective or complete. Recognizing these challenges, Archimedes offers specialty drug management solutions for health plans, TPAs, employers, labor groups, and other plan sponsors across the U.S, without any potential conflicted financial relationships with specialty pharmacies or PBMs. Like the scientist and inventor who provided the inspiration for our name, we leverage an unmatched combination of analytic expertise, technological capabilities, experience, and pragmatism to provide plan sponsors with the support that they really need to control the growing cost of specialty drugs across the pharmacy and medical benefits. Fundamental to our business is the belief that full visibility into the economics and clinical performance of a specialty drug program is critical to making informed decisions concerning specialty drug management.
- Website
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http://ArchimedesRx.com
External link for Archimedes
- Industry
- Hospitals and Health Care
- Company size
- 11-50 employees
- Headquarters
- Brentwood, Tennessee
- Type
- Privately Held
- Founded
- 2016
Locations
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Primary
Get directions
278 Franklin Rd.
Ste 245
Brentwood, Tennessee 37027, US
Employees at Archimedes
Updates
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Many plan sponsors are closely watching the employee lawsuit against J&J, claiming the company breached its fiduciary duties to spend health benefit funds responsibly by overpaying for generic medications. While there has been greater attention in recent years to the financial conflicts of interest inherent in large #pbms, this lawsuit highlights the responsibility of the self-funded plan sponsor in holding PBMs accountable in controlling plan costs. At Archimedes, we are proud of the work that we do to lower the cost of #specialtydrugs for our clients. Under the mindset of "managing every dollar as if it were our own" we reduce specialty spend by 25 - 50% in the first year with savings sustained over time. In fact, our specialty PBM program was cited in three separate examples in the J&J lawsuit documents as an example where plan sponsors are doing the right thing for their plan. If your PBM isn't producing results like this, it may be time to see how working with a transparent, aligned PBM with a laser focus on specialty drug benefits can produce significant savings while taking great care of your members. #alignment #transparency https://lnkd.in/gdNQe6gg
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Adalimumab biosimilars are great alternatives for a number of specialty drugs that treat autoimmune conditions, offering a strong value for plan sponsors as evidenced by the 27% reduction in spend YOY in this class across Archimedes' BOB. This is a great win for patients as well, who receive the care they need at a lower cost while maintaining a positive member experience. #hr #specialtydrugs #pharmacybenefits
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We are proud to offer our clients specialty drug programs that are free from conflicts and highly effective in controlling specialty spend. #specialtydrugs #pharmacybenefits #hr
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Employers do not have to settle for 13%+ trend for specialty drugs. This Purdue University case study by Eric Bricker, MD highlights what is possible when employers apply smart and effective techniques for managing spend. This progressive #HR team was able to generate significant savings through a covered specialty drug benefit while providing members with the care they need. Purdue's remarkable results for specialty drugs are consistent with that of other Archimedes clients after moving management of #specialtydrugs from traditional PBMs, as evidenced by the following book of business stats from 2023: -94% Biosimilar Fill Rate -89% Generic Substitution Rate -40% Prior Authorization Change Rate -30-50% first year reductions in spend -$26.25 PMPM specialty drug spend net of rebates #pbms #pharmacybenefits https://lnkd.in/ghQN_jzC
Employee #HealthPlan Case Study - Purdue University Keeps Trend at 1% Per Year for 7 Years!! National Average for Universities is 6X Higher. How Purdue Did It: 1) #OnsiteClinic Run by One to One Health. 2) #Tiered In-Network Benefits with Tier 1 (lower deductible and coinsurance) for doctors and hospitals that are paid based on outcomes (Value-Based) and Tier 2 (higher deductible and coinsurance) for providers that are paid traditional fee-for-service. 3) All health plan members are on a Consumer-Directed Health Plan with an #HSA incentive to have an annual physical and perform other activities to keep themselves healthy. 4) #SpecialtyPharmacy is carved out from their #PBM... for most employers specialty pharmacy is 51% of their total pharmacy spend. Results: 1) Purdue has #saved $149M since 2016 and the employees have saved $50M. That is an amount of money equal to 1,637 4-year scholarships for Purdue students and $2,778 in the pocket of each and every employee. 2) #Mammogram rates went from 52% to 72% and #colonoscopy screening rates went from 28% to 60%. #Why Purdue Was Successful: The Senior Director of Benefits, Candace Shaffer, M.S., CWPM Shaffer, said Purdue's Success was due to her #benefits team of 26 professionals. Not her vendors. Not her consultants. Purdue's own #internal benefits employees were the key to success. Twenty-six employees is A LOT of employees for benefits. #Conversely, the Head of Benefits of a 7,000 employee manufacturing company and the Head of Procurement at a Fortune 500 company both said the #LACK of their own robust internal teams was their #barrier to a high-performing employee health plan. You can't get something for nothing. If you want to reduce your employee health plan #ClaimsCosts and improve #healthcare quality for plan members, then you have to spend money on the internal employees to make it happen. Sources at AHealthcareZ YouTube Channel.
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Maximizing rebates is not the path to lowest net cost or true clinical care. Insist on rigorous clinical management and an aligned business model from your PBM. #pbms #specialtydrug
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Archimedes team members are passionate about taking great care of our members. This member went out of their way to share their heartfelt appreciation for the compassion and diligent support they received from our member services representative. Providing great member experiences through our high touch approach is an integral component of our specialty drug programs. #specialtypbm #pbm #hr
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Many high cost specialty drugs have lower cost, equally effective alternatives. Therefore, evidence of trial for first line agents is an important part of clinical criteria for specialty drugs. In this case, the Archimedes clinicians worked with the members physician to discuss the case and the alternative therapy. This collaborative approach resulted in the physician's cooperation in taking the message back to the member, resulting in significant savings while ensuring quality patient care and a positive member experience. #specialtybenefits #pbm #hr
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The significant growth of Skyrizi even though much lower cost biosimilar alternatives are available is no surprise. This is a classic strategy from pharma’s playbook – as generics and biosimilars come to market, pharma works to move patients to other high cost brands in their portfolio. With an astounding 48% growth in Skyrizi utilization in Q1 2024, it’s clearly working - leaving plan sponsors and patients to bear the burden. Archimedes’ BiosimilarsFirst strategy is tackling this head on. Our value-based formulary strategy and rigorous approach to clinical management have yielded a 63% reduction in Skyrizi spend for our clients during the same time period. Reach out today to find out how we can do the same for you and your members. #pbm #specialtypharmacy #hr
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