Apollo Vanguard

Introducing a Public PBM with a Canadian Rx Program

2024-02-27

Introducing the first of ever solution to controlling the spiraling high cost of drug prescriptions for public organizations with at least 3,000 members and offer a self-insured health plan. By combining the services of ArrayRx, the only Public PBM in the nation, and that of Apollo Vanguard with a Canadian specialty name brand prescription mail-order program. ArrayRx provides low cost prescriptions with an extensive pharmacy network and completely transparent without hidden fees. With Apollo Vanguard you will have access to specialty prescriptions at 30% to 70% savings as compared to the PBM market.

The Public Plan Sponsor has a fiduciary responsibility to provide the best access, low cost and prescription services to its organization and members while at the same time being good tax stewards to its community. That is what we offer! Review the attached presentation for further information on both ArrayRx and Apollo Vanguard and see how combining both services could optimize savings.

For Public Organizations with less than 3,000 members, the Canadian Prescription Outsource Program with Apollo Vanguard remains an options as a stand-alone option with your current PBM. Let’s keep pushing forward to save on prescriptions the best way possible.

Very truly yours,

Armando F. Polanco, CEO
Apollo Vanguard, LLC
Office: 833 793-7847
Cell: 210 380-1206

Public Organizations part of the total Prescription Public Cost

2024-02-26

If you are a Public Organization with a self-funded plan, it is expected you will be part of the 46% total expenditures of prescription public cost in 2024! The chart below shows changes in absolute spending, by payer.

Here's what CMS is projecting:

Public funds will overtake employer-sponsored spending. CMS projects that public funds will account for 45% of outpatient retail prescription spending in 2023, while employer-sponsored private health insurance’s share will drop to 38%. Last year, CMS projected that employer-sponsored insurance’s share would amount to 43% in 2022, so the newer forecast implies a faster decline.
Individually-purchased insurance will account for 5% of drug spending. This category includes Medicare supplemental coverage and individually purchased plans, including coverage purchased through the federal and state marketplaces. CMS expects enrollment in individually purchased private insurance plans to grow, from 20.5 million people in 2013 to 32.5 million people by 2023.
Consumers will account for an ever-smaller share of drug spending. Consumer out-of-pocket funds—the sum of cash-paid prescriptions and consumer co-payments—will decline to 12% in 2023. This will continue a long-term trend.

Stay tuned for a viable solution on my next email…

Recent News on the rise of Drug Prices

2024-02-19

CNBC reported that Tyson Foods dropped CVS as their pharmacy benefit manager as upheaval over cost concerns spread. This is in order to set some cost containment for their 140,000 employees.

At Apollo Vanguard, we are carving into the specialty name brand prescription offer that cuts away much of the prescription expenses seen by the self-insureds. The Rx List will give you targeted prescriptions for immediate savings! Send me what you have identified and I can assist you with the rest.

Drug costs are 3X in the U.S. what other countries pay, study finds

2024-02-16

Dear Reader,

Medicare is looking into legislation for price negotiation for certain brand name prescriptions. The article goes on to say that even after a possible price reduction due to discounts and rebates, US costs will remain significantly higher.

Drug costs are 3X in the U.S. what other countries pay, study finds

Industry observers said that drug companies are likely to continue to oppose the government’s efforts to reduce prices…keep in mind this will most likely not change prices for the private commercial market and potentially increase it as a cost shift measure.

Let me know if you would like a savings comparison for the specialty name brand prescriptions on your list!

Big Pharma raised prices on 1,450 drugs

2024-02-14

Last year Big Pharma raised prices on 1,450 drugs as seen from linked article: https://www.fiercepharma.com/pharma/ira-inflation-price-caps-loom-pharma-kicks-2024-hundreds-price-hikes-report.

It is expected that it will be similar this year, with a range of 5% to 10% increases. Most prices are felt in the beginning of the year, with a second wave sometime mid-year. There are also many drugs that trickle up in prices during the year so that no shock is felt.

Pharma CEOs grilled by Senate over high drug prices, but point finger at PBMs

2024-02-10

Dear Reader,

Great read below on who sets the prices on prescriptions in the United States.

Pharma CEOs grilled by Senate over high drug prices, but point finger at PBMs

The CEOs of Merck, Bristol Myers Squibb and Johnson & Johnson faced a barrage of questions on Capitol Hill from Sen. Bernie Sanders (I-VT) and other members of the Health, Education, Labor, and Pensions committee. Please allow me the synopsis conversation between Senator Bernie Sanders and one of the manufacture's CEO.

Bernie Sanders asked…“Will you commit today to reduce the list price of the prescription in the United States to the price that you charge in Canada, where you make a profit?”

CEO response…” Senator, we can’t make that commitment, primarily because the prices in these two countries have different systems, he said, adding that the company has paid billions of dollars in rebates to intermediaries that unfortunately do not go to lowering the price of the medicines.”

Two of the prescriptions cited in the article that are provided by Canada is Eliquis with 70% savings and Stelara with 40% savings.

Apollo Vanguard stands ready to help you Get your Specialty Name Brand Prescriptions costs under control