The key to Pharmaceutical Horizons’ services is customization. Since no two clients have the same needs, we help identify and define the programs and services that will benefit each individual plan.

The knowledge and expertise of Pharmaceutical Horizons’ staff in the area of pharmacy benefits is available to guide our clients in making informed choices when designing or modifying their prescription drug programs. We can also be a plan’s consulting pharmacist on demand.

Performance Evaluation Level 1
A summary of plan performance vs. regional benchmarks allows for performance comparisons. Quarterly, we produce a set of eleven trend charts that graphically depict drug costs and use over a rolling 12-month period.

Financial and Plan Management Reports:

Amount Paid PMPM = total charge - member copay x utilization

Rxs PMPM = number of Rxs dispensed per covered life each month

Amount Paid/Rx = total charge – member copay

Average Drug Cost/Rx = allowed drug cost for both brands and generics

Average Dispensing Fee/Rx = service fee paid to pharmacy per Rx

Member Copayment/Rx = member’s share of cost for each Rx

Generic Index = ratio of actual substitution to potential substitution

Generic Substitution = generic dispensing as a percent of total Rxs

Brand Drug Cost = average cost of each brand drug per Rx

Generic drug cost = average cost of each generic drug per Rx

Total Charge/Rx = allowed drug cost + dispensing fee

Performance Evaluation Level 2
This is a natural progression following identification of possible problems that show up during the quarterly review of the plan financial and management reports. We describe for client's changes in their drug class and product use and how this impacts plan costs. Comparison of the current year with the previous year helps identify costly areas and offers an opportunity to seek lower cost alternatives.

Top Drug Study

A plan specific report indicating the top drugs dispensed for members by cost and volume.

Therapeutic Class Study

A plan specific report indicating the drug classes dispensed for members by cost and volume.

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