True Rx Cost Saving Measures – Benefiting Our Clients and Their Members
No MAC Spreads
A MAC spread, or Maximum Allowable Cost spread, is the difference between what a PBM pays the pharmacy for prescriptions compared to the amount the PBM bills the employer for those same prescriptions. True Rx charges the employer the same amount that we pay the pharmacy. There are no markups and no hidden costs.
90-Day Prescriptions / Retail Pharmacies
True Rx allows 90-day prescriptions to be filled at retail pharmacies instead of using mail order. This helps cut costs and increases convenience for members, True Rx members may order their prescriptions from more than 60,000 retail pharmacies across the nation.
Generic Utilization Programs
- Generics First
Under this program, True Rx notifies members when their prescribed brand-name drugs have cost-effective generic equivalents. Both employers and members save money on medication costs when members choose to switch to the generic equivalent.
Once a member notifies True Rx they want to switch to a generic drug, we communicate the change to the employee’s prescriber and pharmacy.
- Step Therapy
The Step Therapy program requires employees to try cost-saving generic alternatives for two months before the equivalent, brand-name drug can be considered. If the generic works well, the employee is asked to continue using it. If, after two months, the employee’s prescriber determines a brand-name version would better meet the employee’s health needs, the employee may switch to the brand-name drug after authorization by the prescriber.
- Formulary Guard
Medications that are “patent-extenders” (higher priced combination medications, ER products without significant pharmacokinetic differences, medications with the same mechanism of action that does not provide significant differences from previous therapies) will be placed on Formulary Guard. All medications on this will reject at the Point of Service and a Prior Authorization from the doctor is required.
True Rx Assist
Specialty medications can make up a significant portion of a plan’s cost, even though very few members may take these medications. True Rx’s Specialty Case Manager works to minimize member/plan medication costs through coordination with Patient Assistance Programs.
100% Pass-through Rebates
Most PBMs negotiate rebates with drug companies, but may not pass the rebates on to clients. With True Rx, all rebates are passed on, in full, to the employer.