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Your Rx Plan

Expert Pharmacy Strategies

Sometimes your employees may need medications in order to recover or to manage a health condition. Retail drugs accounted for 21% of employer health benefits in a recent study.* To make that money work its hardest, the MedCost team applies expert pharmacy strategies at every phase of the pharmacy spend while educating members on clinically appropriate and cost-effective drugs.

* Study Information


Specialty drugs are 1% of drug use, but approximately 38% of all drug spend.*

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Everything You Need to Administer Your Drug Plan

  • Our partnership with a national pharmacy benefit manager (PBM) helps us provide competitive pricing and rebates, preserving pharmacy dollars

  • Customized plan recommendations designed for your employee population and health plan

  • Expert integration of medical data with PBM claims for a 360-degree view of your members' health while balancing costs

  • MedCost support team of experienced nurses, case managers and pharmacist throughout the continuum of care

  • Data analysis with detailed reporting to identify cost-saving opportunities, increase drug adherence and effectiveness, and encourage safe usage

  • Full cost transparency for decision-making and better asset management

  • Plan design for ACA requirements, clinical programs and co-pay structure


Rx non-adherence results in 26% of readmissions.*

* View Results

Balancing Costs with Employee Satisfaction

MedCost’s dedicated account managers are there for you on a daily basis working in concert with the pharmacy benefit manager. With live access to pharmacy claims data, our customer service and clinical teams can support your members wherever they are. Our in-house licensed pharmacist reviews your company’s pharmacy use patterns for cost savings. Quarterly analysis of pharmacy data reports provides plan design recommendations. Your employees benefit from member education, monitoring, proactive side effect management, adherence assessment, clinical support and prompt answers to their pharmacy questions while your health plan benefits from cost-containment strategies.



MedicalRx Rebates Program

To further manage health plan costs due to specialty medications, MedCost clients* can take advantage of manufacturer drug rebates for certain medications paid for under the medical benefit. The list of rebate eligible medications is updated periodically.

*Although managed through MedCost’s partnership with OptumRx, the MedicalRx Rebates program is available for all MedCost Benefit Services clients, regardless of their PBM.


Understanding the Rx Conundrum

Overcoming the Obstacles Involved in Managing Drug Costs

Controlling Specialty Drug Costs