Mercer partnership tracks rising drug costs and potential opioid abuse
Employers are alerted in real time when prescription drug prices skyrocket, thanks to a partnership between Mercer and a Utah-based PBM analytics company called Xevant. Data analytics provided by Mercer and Xevant — made available at the start of this year — will help employers audit their health plans for cost efficiency.
In the United States, people spend $1,200 on prescription drugs per person every year — more than any other country in the world, according to a study by Organization for Economic Cooperation and Development. It’s no surprise employers want to control those costs as much as possible; in a Mercer study, 68% of employers indicated that “managing costs of specialty drugs” is a top priority in their benefit strategy for the next five years.
“Today’s employers are faced with the significant challenge of navigating the dynamic pharmacy benefits environment without the knowledge and automated tools that can drive meaningful, lasting change,” says Brandon Newman, co-founder and CEO of Xevant. “By combining Mercer’s pharmacy insights and market leadership with Xevant’s performance optimization software, plan sponsors can efficiently achieve new levels of cost savings and improved member health.”
Xevant’s platform provides employers with real-time data from more than 20 other PBMs and insurance carriers. Employers can use the data to determine if their PBMs are performing according to expectations, and to get a better sense of how much their workforce spends on prescription drugs. The partnership gives those same employers access to Mercer’s pharmacy and financial experts, who can help benefit professionals make health plan decisions based on Xevant’s data.
“Since the data is in real time, the idea is to use it to take corrective action when there’s a price increase [on prescription drugs,]” says David Dross, managed pharmacy specialty practice leader at Mercer. “Then we can work with the plan sponsor to identify alternatives in the same therapy class.”
Dross says Xevant’s software can also help HR departments detect and prevent opioid addiction within their workforce. Opioid addiction costs the U.S. economy $78.5 billion a year in “costs of healthcare, lost productivity, addiction treatment and criminal justice involvement,” according to the Centers for Disease Control. Unfortunately, opioid abuse often stems from legitimate prescriptions, which is why it’s critical to keep track of them, Dross says.
“ I don’t want to see a doctor give out a 30-day prescription for opioids — that leads to addiction,” Dross says. “Five days is more appropriate for recovering after a surgery.”
Dross says Xevant is also able to monitor when employees ask multiple doctors to fulfil opioid prescriptions — often a red flag of abuse. In cases where prescription painkillers are still needed, employers can use Xevant’s database to steer employees toward alternative medications that aren’t addictive.
“Until now, employers have not had the right data, at the right time, with the right analysis and insights to forecast trends and drive meaningful changes within their pharmacy benefit offerings,” Dross says. “We believe our collaboration with Xevant is a true innovation for sponsors who want better foresight and outcomes from their prescription spend.”