High-cost and specialty medications can significantly drive up a health plan’s costs. By enrolling members in Manufacturer’s Assistance Programs (MAPs) and sourcing drugs internationally, a plan can dramatically reduce these costs, sometimes by up to 80%.
Through MAPs, drug manufacturers sometimes offer medications at huge discounts for members who meet certain financial criteria. International sourcing is exactly what it sounds like: because many drugs are less expensive in other countries, health plans can sometimes buy the drugs internationally and bring them into the United States, effectively getting them at a discount.
Frequency: low-medium (depending on the number of members receiving relevant drugs)
Impact to quality: none
Impact to cost: high
Kevin Schlotman discusses the misaligned incentives in status-quo healthcare plans, and what employers can do to gain independence.
In the fourth part of our recurring series on healthcare arbitrage, we explain how plans can use steerage to help members get the same care at a lower cost.