You Might Pay Zero, But Your Company Pays $7,600 Per Shot

We break down how a “$0 copay” specialty drug can cost an employer $7,600 per injection and why that gap exists. Then we show how transparent sourcing cut Enbrel from $38,000 a year to about $2,000 without sacrificing care.

• how Enbrel is marketed versus what it treats
• the hidden employer cost behind copay programs
• five fills adding up to roughly $38,000
• plan risk thresholds and why unit cost matters
• sourcing the same medication for $400 per fill
• scaling savings across more specialty drugs
• why healthcare needs real price transparency

Let me know if there's any topic we want to cover in the future

Music by Alex Lambert.

Transcript

What Imbril Treats And Ads

The Real Price Tag Revealed

Who Really Pays And How Much

Smarter Sourcing Cuts Costs

Transparency And Next Steps

SPEAKER_00 0:19

Welcome to another Tuesday morning with Justin. I'm Justin Futrell Benefits Advisor at True North, and today let's talk about Imbril. What is Imbril? Imbril is an injectable medication that is commonly seen on TV with those beautiful sounding playing in the rain or jumping through the fields with all of those side effects listed below. It serves rheumatoid arthritis and plaque psoriasis. It can be a really effective drug. And putting aside the jokes about the TV commercials, it's really helpful for a lot of people. Now, the cost, as we were just reviewing a company's health plan, was$7,658 for one script, one-time injection. Now, it is advertised if you look up Imbrill, if you want to Google it, pay as little as$0 with our copay program. And you'll see something that says something like support is available at any income level. And so you have a drug manufacturer of Imbril marketing to people that they don't have to pay a dime for this. So there's no known concept of how much this cost. Yet on the back end for the company, it's$7,600. So I asked, how many fills did you have throughout the year? And there were five fills. So we're looking at roughly$38,000 in drug medication prices for just five fills throughout the year. That's$38,000 in addition to that person's salary, right? People, we don't really think about these things until we realize what happens behind the scenes and how much our companies pay for healthcare. So if companies are taking on that risk and paying up to a certain amount, call it$50,000,$100,000 for every person on within their company, how do we get smarter about that$38,000? We can source Imbrill, the exact same medication, for$400.$400 times five fills is$2,000. So instead of paying$38,000 throughout the year, this company is coming to learn that they only have to spend$2,000. That's a$36,000 difference for just one person on their health plan. If that's what we can do with one drug, imagine what we can do with hundreds of drugs. The healthcare world needs more transparency. And we're gonna do our best to keep bringing it to you. That's what we have for today. Let me know if there's any topic we want to cover in the future.