Episode 10: Cost Savings, Innovation & Revolutionizing Pharmacy Benefits with Chloe Bright

In this episode of the Bending the Trend we are thrilled to welcome Chloe Bright, Founder & Lead Consultant of Acumen Consultants, Inc. Chloe shares her expertise on innovative pharmacy solutions, including niche PBMs, pharmacogenomics, and future industry needs. Discover how these strategies can lead to significant cost savings and improved healthcare outcomes for employers and members.

Key Topics

💊 Niche PBMs and their advantages
🧬 Role of pharmacogenomics in cost savings
🚀 Emerging pharmacy technologies and solutions
⚠️ Industry challenges and future needs

Chapters

00:00 Introduction to Chloe Bright and her expertise
00:19 Chloe's background in benefits and PBM consulting
00:43 Key qualities in selecting pharmacy vendors: Flexibility
01:11 Top niche PBMs Chloe recommends
01:40 Technology innovations improving member experience
02:09 The impact of pharmacogenomics on healthcare costs
02:31 Reducing polypharmacy and adverse drug events
03:05 Precision medicine in pharmacy
03:33 Emerging specialty pharmacies and cost management
04:20 Results and data showing cost savings from niche PBMs
04:49 Typical savings percentages and financial impact
05:17 Reinvesting savings into employer and employee benefits
06:02 Industry needs: Better vendor communication and ROI tools
07:02 The concept of a vendor integration platform
08:08 Future solutions to improve vendor collaboration
08:50 Closing remarks and industry outlook
09:02 Bending the Trend Outro

Transcript

SPEAKER_01 0:00

We have to find real solutions, and this is bending the trend. Hello and welcome back to Bending the Trend with your host, Norm Volski. And today we are thrilled to be joined by Chloe Bright, who is the founder of Acumen Consultants.

SPEAKER_00 0:19

Fantastic. Thanks for having me. Very excited to be here.

SPEAKER_01 0:22

Yeah, very, very excited to have you. So we'll jump right into it, Chloe. You know, you're a benefits consultant and uh PBM consultant by background. Which vendors have you implemented over the last handful of years, you know, with clients that you would recommend to others because they've done such good work for you?

SPEAKER_00 0:43

Fantastic. Yeah. I mean, I have to say, you know, really I try to go for vendors who have one main thing in common, and that's flexibility. Flexibility is so important. Um, especially, you know, over the years with all of the new regulations and the employer groups really starting to peek behind the curtain to see, like, oh, well, you know, I really wanted this out of my PBM and I wanted that out of my out of this, you know, wellness vendor. It's very important to me to make sure that I work with vendors that are flexible. Um, at the top of my list, I'd have to say are the newer niche PBMs that are coming to the forefront here. Recently, I've worked with, for example, and I'm probably gonna say RX a million times because everybody's got RX in the name, but um, at the top of my list are definitely uh USRX, April RX, Disclosed RX, um, Well Life is doing some pretty cool things there too. Um, you know, and then there's just a handful of others, some of the newer niche PBMs. Um, and I have to say that on in addition to the flexibility, they really uh have a lot of good technology options in place for the members to have a better experience with their health care, making them smarter shoppers, of course, for doctors and you know, pharmacies, finding better prescriptions. Um, and I've really seen a turnaround in the not only quality of the service, but just the overall experience for the employers as well as the members with using PBM such as this. Um, in addition to that, I'm a huge proponent for precision medicine.

SPEAKER_01 2:02

Yep.

SPEAKER_00 2:03

Pharmacogenomics, PGX, you know, for short. The vendor that I work with is Cygenics. And they've really, they're the ones that really have an option or a tool that the employer groups can use that is making an impact not only on improving the health and well-being of their members, but seeing the huge savings and downstream claims, um, and reducing polypharmacy. We don't have patients that are on five or six or seven different medications that are trying to fix the side effects from medication number one. Um, fat reduction alone, um, and just the impact that it has on adverse drug events. You know, I heard someone say before that the most expensive prescription is the one that sends you to the hospital.

SPEAKER_01 2:40

So being able to Or the one that makes you feel so bad that you don't even take it as regular condition exacerbates.

SPEAKER_00 2:48

Exactly.

SPEAKER_01 2:48

So if someone is not taking their drugs because how it makes them feel, that's one of the biggest issues in healthcare.

SPEAKER_00 2:57

Exactly, exactly. You're spot on, you're spot on. And that and that's why with a tool like precision medicine, where we're using the genetic data and the metabolism for each individual to make sure that those prescriptions are working correctly from the first prescription, that's really sending shockwaves through what those traditional cost containment pharmacy tools are, as opposed to the cygenics tool that I've been working with recently. And my prospects and clients are really excited about the impacts on that. Um, aside from those guys, lastly I'd have to say are the newer specialty pharmacies that are out there, um, such as Cindera. Um, I've worked with uh mail orders like Plat RX, um, and there's an international pharmacy, OIL Meds, that's really helping to rein in those costs of those higher cost prescriptions out there. And it's given employer groups a better chance to not only make better decisions on formulary, but also to be able to forecast their spending in the future with implementing a pharmacy such as that. So it's really making a difference in the pockets and the quality. You know, those two go hand in hand, you know, for employer groups.

SPEAKER_01 3:57

I love it. And for our viewers and listeners, Chloe is just extremely knowledgeable and niche within pharma consulting, you know, pharmaceutical, you know, PBM consulting. Um, so, you know, really, really helpful there. What were some of the results of some of these implementations that caused you to say, hey, they're doing great work? Like what's some of the data behind it?

SPEAKER_00 4:22

For sure, for sure. Um, yeah, like with you know, some of the niche PBMs, we're just seeing differences, especially when we've got an employer group that's moving away from one of the big three or big four, seeing a difference in just the spending has been, I mean, just tremendous.

SPEAKER_01 4:35

You know, what type of cost savings are we talking on pharmaceutical spend? Pharmacies.

SPEAKER_00 4:40

Um, we're probably seeing anywhere from like, you know, 20%. In some cases, it can go a little bit higher. No, it really just depends, you know, because it's so different.

SPEAKER_01 4:48

Millions, if not tens of millions of dollars on savings.

SPEAKER_00 4:51

Exactly. You know, and when you think about it, you know, sometimes, you know, in pharmacy or in PBM, you know, we think about like, oh, per member per month or per employee per month or per script. But really, when you look at like the end of the year or just comparing from apples to apples, what you were spending with a huge PBM as a as compared to like a niche PBM, it's really giving employers an opportunity to take those savings and reinvest them back into the company, reinvest them back into the employees. Um, you know, and it really opens up a whole new, well, several new windows, I would say, for success for the employer group. So it's really amazing what we're able to see there, just from that flexibility, you know, being able to change something as simple as a specialty spend or something as simple as like, you know, claims processing. Um, that doesn't cause huge disruptive disruption, doesn't cause a lot of uh time loss or anything like that. Um, you know, cash like that can be resolved. So it's really amazing.

SPEAKER_01 5:39

I love that. Very good. And are there any solutions you wish existed that do not that you are hoping someone comes out with?

SPEAKER_00 5:48

You know, you know, and I've been thinking about this. This is a really interesting question when you first posed it to me um, you know, a couple of weeks ago. And a couple of weeks ago that solution made since then, and then like the week after that, I needed something new. And then the follow-up. It's such a you know, a constantly evolving um industry that we're in, and things change so quickly, you know, from day to day. But I think the one thing that has remained constant that would be very helpful is if there was some sort of tool and not like another point solution, not like another platform, um, but something that would make it easier for vendors to speak to each other and to be able to show employers return on investment instantly. You know, and take for example, like say if I've got an employer that implemented a new uh PBM and implemented a new PGX solution and got a new specialty pharmacy. Separately, all these organizations are great. They're all working fine, they're spot on, on paper, it looks good. What we really see the impact that we need to see is how all of them are working together. So if there is a way to make sure, and this tool would have to be, of course, agnostic. You know, if it was something that was created by one of these vendors, of course, there would be a interest, definitely. But if there was a way to see that, okay, um, after we implemented pharmacogenomics, um, the claim started going down, and the specialty pharmacy didn't have to fill these high cost medications, we were able to de-prescribe, you know, so that we could see how each of these were working together and the overall impact it was having for the employer. So something like that, I think, would be very useful to make it easier to manage or easier to measure a return on investment.

SPEAKER_01 7:22

I love it. It's awesome. Yeah. It's almost what like the HIEs were for the EMR space, where like EMRs that didn't talk to each other, and it's an interface that allows patient data to flow back and forth. It's almost like the same thing needs to exist in the other space.

SPEAKER_00 7:40

Yeah, that's exactly that's exactly what I'm talking about. You know, and of course the benefits um teams, and we don't want something that's gonna add more headache for them, of course. You know, some of these companies, really, really small benefits departments, there might just be one HR director, you know, and that's it. So if it was something as simple as, you know, like I said, I'm not thinking like another app or anything like that. A lot of people complaining about app fatigue, you know. If that I'm not sure how simple it would be, but I'm sure there's somebody smart out there in the industry that already has this figured out and is just waiting to push go on it. But that would be very helpful, very helpful for someone in my position.

SPEAKER_01 8:11

Um I'm only kind of chuckling because you may see something soon. Um market that you know addresses this issue. So stay tuned.

SPEAKER_00 8:22

I'll be all for it. I'll be all for it. Can't wait.

SPEAKER_01 8:24

Love it. Well, Chloe, thank you so much for joining us on the Bending the Trend podcast. Thanks for everything you're doing with your clients to bend their pharmacy trend. Absolutely. And uh for all of those out there listening, watching, there is a life beyond the big three PBMs. Ways to uh provide better value to your employees and get more of those dollars back into their pockets and keeping their hard-earned money um in their pockets and not in the healthcare system. So thank you so much for doing what you're doing and uh keep us posted on the progress.

SPEAKER_00 9:00

We'll do, we'll do. Thanks so much.

SPEAKER_01 9:02

Thanks, Chloe. Thanks for watching Bending the Trend, where we are looking to fight rising health care costs. We are asking benefits leaders what digital health solutions they've implemented that has helped them bend the trend.