PharmaSavings Program

The PharmaSaving Program offers a unique platform that allows PBMs and other organizations to improve client retention and new client acquisition. It helps to alleviate the financial burden placed on employees/members as well as providing employers with a powerful health plan benefit offering. It can help PBMs increase revenue and script fulfillment while linking to existing client wellness programs.

The PharmaSaving Program provides additional monetary benefit to a patient under the program by paying a portion or the entire co-payment obligation of the patient, based upon specific program rules. The program allows an Employer, Drug Manufacture or other third party to subsidize the patient's co-payments, based upon the use and rules established by the funding agent. For example, a drug manufacturer may subsidize the purchase of a brand drug (where there is no generic available) to encourage continued use and compliance by the patient.

Taking a card-centric approach to facilitating healthcare payments, the card serves as a proxy for identity and is thereby used to determine eligibility for specific programs attached to the patient. The card also identifies which specific programs and rules apply to a given purchase; for example, the patient participates in the PharmaSaving co-pay assistance program. For financial transactions, the card accomplishes automatic adjudication and payment of a portion of the patient co-payment obligation for a prescription.

WiredBenefits' proprietary system that enable this innovation in healthcare payment processing includes the auto-adjudication processor. It analyzes the pharmacy transaction and determines co-pay assistance eligibility, facilitates payment of 'adjusted co-pay' at the front of store, and processes and settles the financial transactions with the funding agency.

The PharmaSaving co-pay assistance program allows a third party to directly fund a portion of the patient's co-payment obligation for purchasing certain prescriptions. It is expected that a self-insured Employer or in some cases the drug manufacturer will subsidize the purchase of certain drugs in order to ensure compliance with the drug regimen. The PharmaSaving card identifies the patient as a member of a group that is entitled to co-pay assistance, as well as being a proxy for transacting with the front-of-store POS to apply subsidy funds to a co-payment transaction.

For more information on the PharmaSavings Program, please contact info@wiredbenefits.com.