In this episode, Michael introduces two partners of ScoutRx, Robert LeCureaux, the VP of Client Development and Amy Bandy, the VP of Operations. ScoutRx helps employer groups and members maintain affordable prescription drug costs through the use of their three core cost containment strategies.
When previously working in the pharmacy and PBM industry in very different roles, Rob and Amy both recognized that it was very profit-driven and not much thought was given to the consumer and the burden of cost. They didn’t like this status quo – and how members had no voice and too many roadblocks – which is what inspired them to team up with other partners to create Scout Rx.
With a lack of marketplace options to address the rising price and utilization of specialty medications, ScoutRx has made it their mission to bring overall costs down and create a better member experience. To date, they have been able to drive an average savings of about 43% for their clients, a sign that they are succeeding in their mission thus far. To be clear, ScoutRx is not a pharmacy benefit manager or administrator. They’ve partnered with a PBM to administer their program while they use their own core strategies autonomously.
ScoutRx operates using three core strategies: Their Specialty Pharmacy Program, Copay Optimization Program, and International Pharmacy Program. Through their Specialty Pharmacy Program, they help members pay little to no money out-of-pocket for specialty drugs by finding drug manufacturer foundations and financial programs that patients can qualify for to offset the entire cost of the drug. The Copay Optimization Program takes advantage of drug manufacturer coupon cards to reduce the cost of the drug and potentially eliminate the patient’s copay altogether. The International Pharmacy Program allows members in the U.S. to get their high-cost or specialty medications from Canada at a substantially lower cost with eliminated copays and reduced cost to the group. The amazing part about all of this is that most of the logistics are done behind-the-scenes at ScoutRx with little effort needed from the patient.
And as far as savings go? Some groups that they’ve worked with had a 96% generic utilization rate and were still able to save over $100,000 in their first year. The savings range in the first year is vast – from 16% all the way up to over 70% – and these savings continue into future years which will lead to lower inflation than employers would see with typical PBM’s and insurance carriers in the industry. ScoutRx is paid a percentage of savings which they outline in regularly distributed, fully-transparent, line-by-line reports.
ScoutRx is a good fit for small-to-midsized self-funded companies with 2,000 employees or less. While ScoutRx is a new company, its leadership team is experienced and its methodologies are proven. ScoutRx has a bright future ahead disrupting our healthcare system by making high-cost prescriptions more easily accessible to patients.
Here’s a glance at what we discuss in this episode:
- 00:30 – Introducing Rob and Amy, two partners for ScoutRx.
- 03:00 – The inspiration for ScoutRx: Rob saw that the industry was profit-driven and that not much thought was given to the consumer.
- 04:30 – Amy saw all the roadblocks between members and their prescriptions in the traditional setting and wanted members to have a better option.
- 06:00 – The key issue with the drug delivery and payment system of today is that specialty medications are often inaccessible to groups and patients.
- 10:30 – Their specialty pharmacy program addresses accessibility so that patients can get pharmaceuticals for little or no cost.
- 11:50 – The Patient Assistance Program – It’s a financially-based program where the manufacturer offers its medication free of charge for those who qualify.
- 13:30 – ScoutRx helps its members through the complex eligibility and qualification process that is tough and expensive to do alone.
- 15:10 – Traditional PBM’s have no interest in this – it’s labor-intensive, hands-on, and concierge-level, plus they get revenue from specialty meds at their in-house pharmacies.
- 18:20 – Copay Optimization leverages copay cards received directly from the manufacturer.
- 22:30 – The International Pharmacy program utilizes a partner pharmacy in Vancouver to get high-cost and specialty medication at a lower cost – and mailed directly to members.
- 26:30 – Rob’s father goes to Canada monthly to get his insulin medication because it’s so much cheaper in Canada and he’s on Medicare.
- 27:50 – They utilize a retail pharmacy, not a broker because there’s no regulation on brokers and they want members to get what they could get at a local pharmacy in the U.S.
- 29:15 – Their international program is voluntary, not mandated, and labeled under “personal importation” – which makes it within all legal limits.
- 31:05 – ScoutRx members see a savings range of 16-70+% in their first year.
- 33:50 – They get paid off a percentage of savings and are transparent about what they’ve earned with regular reports.
- 35:45 – ScoutRx could be a good fit for small-to-midsized self-funded companies with 2,000 employees or less.
- 38:20 – The worst-case scenario of moving to ScoutRx would be that you’re in the same position you’re in now; it isn’t too good to be true.
- 40:55 – They’re working with about a dozen employers now; their concept may be new, but their methodology isn’t.