Payer Matrix outlines significant savings for county's drug cost management

A groundbreaking proposal to enhance drug cost savings for Kootenai County employees took center stage at the Board of County Commissioners meeting on July 9, 2025. The discussion revolved around the potential implementation of a patient assistance program (PAP) through PayerMatrix, which could lead to significant financial relief for both employees and the county.

The key highlight of the meeting was the revelation that if all eligible employees qualified for the PAP, the county could save approximately $1.13 million annually. This program would allow employees to access certain medications at no cost, a stark contrast to the current co-pay system. PayerMatrix would facilitate this by reaching out to employees to assess their eligibility based on household income, not just individual earnings.

PayerMatrix's approach includes a tiered system for sourcing medications. If employees do not qualify for the PAP, they may still benefit from bridge programs offered by pharmaceutical companies, which provide drugs for free for a limited time. Additionally, the company can source medications internationally, particularly from Canada, at a substantial discount—up to 50% off the current prices.

Specific examples highlighted during the meeting included high-cost drugs like SKYRIZI and Renvoke, which could lead to substantial savings if sourced through PayerMatrix. For instance, the annual cost for three employees on SKYRIZI is around $204,000, but international sourcing could drastically reduce that expense.

While the potential savings are promising, the discussion also acknowledged the complexities involved. There may be disruptions for employees as they navigate these changes, and not all drugs are eligible for the PAP. The county is urged to consider these factors carefully as they weigh the benefits of partnering with PayerMatrix.

In conclusion, the Board of County Commissioners is poised to make a decision that could reshape how employees access medications, potentially leading to significant cost savings and improved health outcomes for Kootenai County residents. The next steps will involve further analysis of the projected savings and the impact on employee experience.