Pharmacy Network Options
Convenient, Cost-Saving Pharmacy Network Options
It is important to ensure your members have access to convenient pharmacy options to get the medications they need. As a national provider, Elixir has one of the industry’s largest pharmacy networks with more than 64,000 pharmacies nationwide, including a variety of local independent pharmacies, and mail and specialty pharmacy services.
We understand that every plan has unique needs and we have the flexibility to offer a variety of pharmacy network options.
Our Broad/Open Network offers the largest network of pharmacies, with over 64,000 pharmacies across the country available to members.
A narrow network can improve plan savings while still ensuring member access to pharmacies. We offer a Narrow/Limited Network option that is geography based and limits the network to major utilizers in the area. This still provides strong member access, with approximately 50,000 to 55,000 network pharmacies, but adds savings from better in-network pricing. Switching from a broad to a narrow network can result in 9.6% savings or approximately $11 per prescription.
Our Preferred Network offers a two-tier copay option, where members are not restricted on which pharmacy they use, however, there is a lower out-of-pocket cost at preferred pharmacies. By increasing utilization at specified pharmacies, you can increase savings.
Non-Specialty Maintenance Medication Management
Studies have shown that when patients taking maintenance medications for a chronic condition move to the convenience of 90-day fills, adherence improves, limiting other potentially costly complications. Elixir’s approach to maintenance medication management improves costs for plan sponsors and members, offers easy-to-access retail and mail pharmacies, delivers timely communications to ensure member compliance, and provides clinical support to improve adherence. This is done through flexible plan designs that incentivize 90-day fills of maintenance medications at customized networks, as well as proactive outreach to educate members on their treatment, particularly non-adherent members, and address any adherence barriers. This program typically saves plans up to 7% annually on total medication spend.