Case Study

Introduction of Step Therapy Stepped Up Savings

Our client’s drug spend had risen consistently over the three-year targeted review period—a total of $2.1M more was spent in 2007 vs. 2005. We did a more detailed review of prescription drug claims and identified costs above benchmark in three key therapeutic classes:

a. Cardiovascular Agents
b. Gastrointestinal Agents
c. Respiratory Agents

Our thorough review of claims data revealed heavy utilization of more-costly, non-preferred brand First Proton Pump Inhibitors and COX-2 Inhibitors. Given that the group did not previously employ step therapy protocols, Banyan identified specific step therapy programs to produce ongoing cost savings. Banyan coupled this with a detailed employee-provider and top provider-pharmacist educational campaign to mitigate adverse employee impact.

By employing the recommended step therapy programs, on only the top two drug spend categories, our client saved $320K in the first year. Banyan provided additional guidance by identifying a total of eighteen, high-volume step therapy programs based upon the client’s specific experience. If all programs are implemented, Banyan estimates total annualized savings to be $650K-$700K.