| Express Scripts – Incumbent PBM | |||
| Total | Retail | Retail | |
| Brand | Generic | ||
| RX COUNT | 7,257 | 2,769 | 4,488 |
| AWP | $809,015.64 | $513,092.61 | $295,923.03 |
| INGREDIENT COST | $587,723.37 | $429,827.37 | $157,896.00 |
| DISPENSE FEE | $8,799.05 | $4,065.80 | $4,733.25 |
| GROSS COST | $596,522.42 | $433,893.17 | $162,629.25 |
| MEMBER COPAY | $50,959.29 | $29,030.77 | $21,928.52 |
| PLAN COST | $545,563.13 | $404,862.40 | $140,700.73 |
| AVG. DISCOUNT | 27.00% | 16.00% | 47.00% |
| TransparentRx, LLC | |||
| Total | Retail | Retail | |
| Brand | Generic | ||
| RX COUNT | 7,257 | 2,769 | 4,488 |
| AWP | $809,015.64 | $513,092.61 | $295,923.03 |
| INGREDIENT COST | $517,006.90 | $432,483.51 | $84,523.38 |
| DISPENSE FEE | $17,672.50 | $6,712.50 | $10,960.00 |
| GROSS COST | $534,679.40 | 439.196.01 | $95,483.38 |
| MEMBER COPAY | $50,959.29 | $29,030.77 | $21,928.52 |
| PLAN COST | $483,720.11 | $410,165.24 | $73,554.86 |
| AVG. DISCOUNT | 36.00% | 16.00% | 71.00% |
| PER YEAR | NOTE | ||
| SPREAD SAVINGS | $61,843.02 | Identified spread (the difference between the PBM pharmacy contract and the PBM plan contract) typically retained by the PBM. | |
| REBATES | $18,142.50 | The average expected Rebate is $2.00 to $3.00 per claim. | |
| GENERIC UTILIZATION RATE | 62.00% | $34,000.00 | Estimated savings on four targeted Generic/Therapeutic Switches. |
| MAIL-ORDER DISPENSING RATE | 25.00% | $29,000.00 | Estimated savings when 35% of Rx’s dispensed via retail change to our mail-order program. |
| TOTAL SAVINGS | $142,985.52 – $36,461.31 PEPM* = $106,524.21 | ||
| *PEPM or per employee per month fee. | |||
PBMs: Traditional vs Fiduciary Repricing Report (Actual)
