USDR PROTOCOLS for PHARMACY BENEFIT MANAGEMENT |
| Annual Costs to Insured |
| |
Year | | Expense Cost US$ 2nd Set |
| | 2015 | | $ 842,127.39 |
| | 2016 | | $1,277,018.75 |
| | Net Increase | | $ 434,891.36 |
PHARMACY FORMULARY MODIFICATIONS by USDOCTOR™ _________________FIRST 25 P.B.M. MODIFICATIONS
| # | Drug
Name |
Disease |
Group Cost/year |
#
Claims Paid |
2015 Cost
per client |
2016 New Cost/unit
GoodRx™ |
Net Total
Increase
w/o PBM |
2016
90-day Price |
Savings from 2015 |
Methodology |
| ____ | _________ | _________ | __________ | ____ |
___________ | ___________ | _____________ | ______________ | __________ | ____________ | |
|
30. | Aggrenox® | Anti-clotting | $ 6,358.74 | 8 | $ 794.84 | $ 477.81 |
| $ 115.40
3 dose pkg | $ 3,134.48 | Exchange
Protocol |
|
31. | Latuda® | Depression | $ 5,885.42 | 8 | $ 735.68 | $ 2,645.48 | $ 2,051.46 | $ 467.50
40mg #90 | $ 2,145.44 | Exchange
|
|
32. | Qvar® | Asthma | $ 5,096.74 | 19 | $ 268.25 | $ 573.65 | $ 5,802.60 | $ 127.30
#3 200dose | $ 1,314.00 | Exchange
|
|
33. | Welchol®/
Lopid | Lipids | $ 4,758.46 | 11 | $ 432.59 | $ 525.88 | $ 1,026.19 | $ 14.45
600mg #90 | $ 4,599.54 | In Class
Naturopathic |
|
34. | Viagra® | E.D. | $ 4,795.93 | 12 | $ 399.66 | $ 1,289.63 | $10,679.64 | $ 26.99
#30 | $ 4,075.92 | In Class
Substitution |
|
35. | Orecea® | Antibiotic | $12,735.35 | 10 | $ 549.68 | $ 778.46 | $ 2,287.80 | $ 60.44
100mg #90 | $ 5,104.10 | In Class
Substitution |
|
36. | Dexilant® | GERD | $ 4,744.18 | 16 | $ 296.51 | $ 642.63 | $ 5,537.92 | $ 16.59
40mg #90
| $ 4,478.72 | In Class
Substitution |
|
37. | Pempro® | Estrogen | $ 4,514.83 | 31 | $ 145.64 | $ 433.72 | $ 4,514.84 | $ 29.99
Premarin
#90-1.25mg
2.5mg $9.99
MPA #90 | $ 3,585.15 | Exchange
Protocol |
|
38. | Jublia® | Fungal Nail | $ 4,475.14 | 9 | $ 497.24 | $ 1,546.35 | $ 9,640.89 | $ 120.00
#3 lacquer | $ 3,395.16 | Compound
|
| 39. | Sumatriptan® | Migraine | $ 4,457.20 | 4 | $ 1,114.30 | $ 277.73 | 3,346.28 | $ T.B.D.
#12 injects | T.B.D. | Generic
Protocol |
|
40. | Brilinta® | Anti-clotting | $ 4,322.98 | 6 | $ 720.50 | $ 264.80 | | $ 470.07
90mg #112 | $ 3,091.38 | Exchange
Protocol |
|
41. | Epiduo® | Acne | $ 4,068.27 | 14 | $ 290.59 | $ 394.96 | $ 1,461.18 | $ 36.21
#1 jar
month | $ 3,561.32 | In Class
Substitution |
|
42. | Benicar® | Hypertension | $ 4,203.76 | 10 | $ 403.38 | $ 638.93 | $ 2,355.50 | $ 83.40
40mg #84 | $ 3,199.80 | Exchange
|
|
43. | Flovent® HFA | Asthma | $ 4,011.82 | 21 | $ 191.04 | $ 615.22 | $ 8,907.78 | $ 88.50
#3 120dose | $ 2,153.34 | Exchange
|
|
44. | Strattera® | Personality | $ 3,755.41 | 13 | $ 233.88 | $ 1,053.63 | 10,656.75 | $ 308.00
40mg #84 | -$ 963.56 | Exchange
|
|
45. | Onglyza® | Diabetes | $ 3,744.68 | 12 | $ 312.06 | $ 1,046.88 | $ 8,817.84 | $ 120.10
5mg #90 | $ 1,919.60 | Exchange
|
|
46. | Amitiza® | Constipation | $ 3,716.90 | 12 | $ 309.74 | $ 952.22 | $ 7,709.76 | $ 334.90
5mg #90 | $ 293.52 | Exchange
|
|
47. | Restasis® | Dry Eyes | $ 3,699.50 | 9 | $ 411.06 | $ 1,228.61 | $ 7,357.95 | $ 100.60
#2 vials
|
$ 5,544.00 | Compound
Substitution
Nandrolone drops |
|
48. | Celebrex® | Pain | $ 3,159.89 | 12 | $ 263.32 | $ 264.93 | | $ 170.00 | $ 1,119.84 | Exchange
|
|
49. | Lupron® | Endometriosis | $ 2,810.09 | 1 | $ 2,810.09 | | | | $ 2,000.00 | Generic
Substitution |
|
50. | Enbrel® | Arthritis | $ 7,598.86 | 1 | $ 7,598.86 | | | | | No
Substitution |
|
51. | Epogen® | Anemia | $ 7,277.75 | 1 | $ 7,277.75 | | | | T.B.D. | Generic
Substitution |
|
52. | Remicade®/ Cimzia®/ Simponi® | Colitis | $61,000.00 | 1 | $61,000.00 | | | | $55,000.00 | Protocol
Substitution |
|
53. | Harvoni® | Hepatitis C | $31,476.50 | 1 | $31,476.50 | | | | T.B.D. | Protocol
Substitution |
