by Al Lewis
In employee health services, almost everyone with internet access is giving out awards for something-or-other. One wellness vendor gave out 25 of them at once, including several to companies that no longer exist, along with an award to itself. Therefore, it can safely be assumed that a light beam leaving these awards wouldn’t reach due diligence for several seconds. Not so with Quizzify’s Valid Vendor of the Month Award. These awards are real. How can you be sure? Not just that each of our Valid Vendors are validated by the Validation Institute, though that’s a great head start. More specifically, Quizzify is so confident of its Valid Vendor selections that we are placing 33% of our own fees at risk for the performance for each Valid Vendor of the Month. While many vendors won’t even put a third of their own fees at risk for their own performance, Quizzify is putting a third of its own fees at risk for another vendor’s performance. The ground rules –and all disclosures—are at https://www.quizzify.com/valid-vendor-awards
I recently met Bill Miller, who runs Drexi. Drexi is a tech company disrupting the pharmacy space with next-generation PBM services compelling enough to win the 2020 Health Value Award from the Validation Institute, as was announced this week (3/30). They also have direct-to-consumer memberships that offer discounts on brand and generics at participating chains, bypassing the standard PBM markup that they charge for “managing” your purchase of a few pills.
Bill told me this. “Sounds great,” I replied, “But it wouldn’t work with me.”
“Why not?” he asked.
“Because I was paying $136 out of pocket for 90 5-milligram zolpidems (Ambiens) at CVS. I tried Optum’s mail order. Same exact price. Then I heard I could purchase them through the dispensary at my PCP’s practice and pay only $18.40.”
In case there is someone reading this who has never been snookered by a PBM “negotiating” for you, here’s what a receipt looks like, for a covered benefit for a generic medication:
Now let’s compare my CVS receipt for $136 -- the price that my PBM had thoughtfully and painstakingly procured on my behalf with CVS, no doubt after several tense negotiating sessions in a smoke-filled room – to the receipt from the dispensary at my nonprofit physician practice.
I bought these zolpidems for a mere $18.40, knocking fully 86% -- 86% -- off the CVS price. No way Drexi can beat that, I thought.
“Well, let me at least try,” Bill offered.
“Fine,” I replied, using the tone of voice I normally reserve for a wellness vendor buttonholing me at a conference to explain that while every other wellness vendor lies and loses money, they really do get behavior change and dramatically reduced costs.
Bill searched on Drexi for “90 5-milligram zolpidem”.
“Is there a Walgreen’s near you?” he asked.
Indeed there is. Turns out that, had I used a Drexi card, I could have gone right across the street from the CVS to the Walgreens and paid $10.40, which I made a note to do in April. This would be a 43% reduction off my 86% reduction. What a savings! What a story!
But wait…there’s more. Now how little would you pay?
That wasn’t remotely the end of the story, as it turns out...I’m pretty close to a Wegman’s, where it turns out I could have gotten those very same 90 pills for: $3.60. This would be a 67% discount off my 43% discount off my 86% discount. Here is the Drexi screenshot.
Yes, way cheaper even than Walgreens. But I live fairly close to a Walgreens, and it’s a much more pleasant bike ride, so I figured I would just go there. I was already way ahead of the game with the $10.60, and it was a nice day for a ride.
And the envelope please…
Between the time Bill Miller showed me the Walgreens price and the date of my visit, Drexi had negotiated an even better deal with Walgreens: I paid – get ready -- $3.25.
Was this a perfect experience? In the broad sense in which that word often gets used these days, yes. On the downside, the pharmacy tech did spend a little bit longer processing my card than typically with my regular insurance. (That may be because I was a first-time user.)
Note: there is an admin fee. The retail-user fee (that I pay) is $7/month for unlimited prescriptions. Since I am saving about $15/month off my already deep-discounted price from my PCP practice, the extra $7 is a no-brainer for me. Plus, Walgreen’s is closer, stays open later, and usually runs a 2-for-1 sale on my go-to OTC remedy, Refresh Plus lubricant eye drops.
And that’s why Drexi is the April Quizzify Valid Vendor of the Month.
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