Pre­scrip­tion Plans that Save

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Pro­fes­sional Risk As­set Man­age­ment In­surance Ser­vices

The chang­ing face of health­care in the United States sig­nals a change for many busi­nesses in­volved in that in­dus­try. David Wilson, Chair­man and founder of Pro­fes­sional Risk As­set Man­age­ment In­surance Ser­vices – also known as PRAM – sees op­por­tu­ni­ties for un­der­writ­ers and au­di­tors, as well as a shift to­ward sav­ings on pre­scrip­tions.

Since found­ing PRAM in Orange County, Cal­i­for­nia in 1989, Wilson adapted tech­nol­ogy to make the business of un­der­writ­ing pre­scrip­tion plans much more ef­fi­cient. Ini­tially formed as a ben­e­fits con­sul­tancy, Wilson looked for a way to quickly dif­fer­en­ti­ate PRAM from other busi­nesses.

“I felt that the pre­scrip­tion drug area was wide open, since there seem to be few con­sul­tants who had any idea about how to con­trol costs in this area,” Wilson told The Suit Mag­a­zine. He paid par­tic­u­lar at­ten­tion to un­der­stand­ing how pharmacy ben­e­fits man­age­ment com­pa­nies or PBM de­velop and con­trol costs. “In most cases the clients didn't have any idea as to what [th­ese PBMs] were do­ing.”

Ser­vices per­formed by PRAM typ­i­cally start with an au­dit. “The process usu­ally be­gins for us an off cy­cle au­dit of the client's pre­scrip­tion drug card pro­gram. It is through this in­for­ma­tion that the client learns for the first time how their PBM – their pharmacy ben­e­fits man­age­ment company – is man­ag­ing pre­scrip­tion drug costs. They be­come flu­ent in un­der­stand­ing what pos­si­ble prob­lems could be as­so­ci­ated with a con­tract that they signed.”

Two pre­scrip­tion pro­grams cre­ated by PRAM help the mem­ber, or cus­tom- er – as well as the plan provider – save money.

“Frankly, we have very ex­cit­ing pro­grams. We of­fer a num­ber of un­der­writ­ing op­por­tu­ni­ties that can curb the im­pact of pre­scrip­tion drug costs on fam­i­lies who have chil­dren with spe­cial needs,” Wilson ex­plained. “The key pro­gram we of­fer un­der PRAM's mail ser­vices al­lows a 90-day sup­ply with zero co­pay for the mem­ber, and at a far less cost for the plan spon­sor than sav­ings avail­able un­der tra­di­tional pharmacy pro­grams.”

El­derly mem­bers re­ceive a sim­i­lar ben­e­fit un­der the plans that PRAM un­der­writes. “Ev­ery ef­fort is made to in­clude them when un­der­writ­ing se­niors for state, lo­cal and na­tional em­ployer groups,” said Wilson. “For se­niors, get­ting a zero co­pay for a 90-day sup­ply of main­te­nance drugs is pretty ex­cit­ing – and frankly, we think it is a one-of-akind pro­gram that con­trols costs dra­mat­i­cally for [se­niors] through­out the coun­try.”

Ac­cord­ing to Wilson, PRAM's un­der­writ­ing ser­vices are avail­able in all but two states, how­ever, PRAM's con­sult­ing ser­vices and self-funded pro­grams are avail­able in ev­ery state.

We are ex­perts in help­ing our clients deal ef­fec­tively with Pharmacy Ben­e­fits Man­agers (PBMs), in­sur­ers and other third par­ties.

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