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Mercedes ISD hears pharmacy benefit review after spike in drug costs; pharmacy import program credited with savings
Summary
Pharmacy benefit managers told trustees the district saw a quarter-to-quarter spike in prescription costs driven by high-cost oncology and biologic drugs and that the district’s international importation program, prior authorization and targeted interventions are already cutting net costs.
Mercedes ISD trustees received an in-depth briefing from the district’s pharmacy benefit manager and benefits consultant on prescription drug spending and the district’s health-insurance fund. The presenter said quarterly drug costs showed an unusual spike in the fourth quarter driven primarily by higher-priced generic fills for a lenalidomide product (generic for Revlimid) and new costly biologic therapies for inflammatory conditions, plus increased spending on GLP-1 agents used for diabetes and weight management.
Patrick McLaughlin, presenting on behalf of the pharmacy benefit manager, said the district’s gross prescription payments for the 12-month period totaled about $1.4 million. Manufacturer rebates—delivered quarterly—totaled roughly $450,000 for the year, bringing the net prescription cost to about $1.0 million. He identified three main drivers of a $100,000 increase between Q3 and Q4: a single member’s…
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