In order to determine how much you should budget to employ the expertise needed to manage your prescription drug program, whether inside or outside the company, you need to answer two questions. Second, estimate by how much this ten-year forecast figure could be reduced by tighter plan design and improved financial terms. The answer to the first question is easy to obtain. Or use whatever factor you think will apply in your particular case. Based on these considerations, the following table is illustrative of the costs and potential savings which could result over the next ten years.
Figures shown are in millions of dollars.
Put in your own figures and calculate your probable costs and potential savings and this simple arithmetic will demonstrate just how important the prescription drug function is. This exercise, then, will enable you to determine how much you should budget to provide your company with the level of experience and expertise required to design and manage the drug program which will deliver the potential savings indicated. Answers to these questions should help you decide if the PBM is positively acting on your behalf to hold drug costs to a minimum or if they are simply acting as a claims processor. Under this option your largest expense would be to employ a full-time pharmacist and the systems support staff to provide the programs you would need to monitor the formulary and other aspects of the prescription drug program. Also expensive would be the leasing of the First DataBank pricing files without which you would not be able to audit the prices.