New pharmacy benefits initiative through Capital Region BOCES and New York State Municipal Benefit Coalition promises substantial savings for school districts, other public sector agencies

Deal involves one of the country's largest Pharmacy Benefits Managers and partnership with California cooperative to provide cost-effective prescription drug coverage for New York schools, municipalities

The Capital Region BOCES and New York State Municipal Benefit Coalition bid awarded to Express Scripts, Inc. for a new pharmacy benefits initiative that is designed to lower the cost of prescription drug plans for public sector employers.

A new pharmacy benefits initiative spearheaded by the Capital Region BOCES promises much-needed fiscal relief from escalating prescription drug coverage for participating public sector employers—mainly school districts and municipalities.

The deal struck between the Capital Region BOCES/New York State Municipal Benefit Coalition (NYSMBC) and Express Scripts, Inc. (ESI), one of the leading Pharmacy Benefit Managers (PBMs) in the country, is expected to save school districts on average 10-15 percent or more on prescription drug plan costs annually. (Note: Actual savings will vary based on individual school district’s data and design of existing prescription drug plan.)

The Capital Region BOCES, in concert with its subsidiary NYSMBC, is the market partner for the New York state public sector to the Keenan Pharmacy Purchacing Cooperative (KPPC). This 280,0000 member cooperative is comprised of schools, municipalities and hospital systems. It allows much smaller entities and consortia in the state to come under the umbrealla of deep discounts, intensive contracting and dedicated pharmacy program oversight without changing their employee benefits.

An apples-to-apples cost analysis of the Capital Region BOCES’ actual pharmacy data revealed a projected cost savings of $500,000 in the first year under the collaborative ESI plan.

The Capital Region BOCES and its affiliate, the New York State Municipal Benefit Coalition (NYSMBC) awarded a contract to Express Scripts, Inc. (ESI) following an extensive 12-month request for proposal (RFP) process. Nine of the largest Pharmacy Benefits Managers (PBMs) in the country submitted bids based on pharmacy data from 40 school districts locally and across New York State compiled by the Capital Region BOCES and the NYSMBC.

Through the RFP award with ESI, an innovative alliance has been established between the NYSMBC and a California cooperative that represents more than 280,000 public employee members. This “east meets west” collaborative effort leverages volume savings that rival a national account or insurance company, and is targeted specifically for the public sector.

In addition to pricing, BOCES and NYSMBC considered other factors when awarding the RFP, such as industry expertise, innovation and a commitment to transparency.

“Many school districts have expressed interest in a pharmacy initiative that provides cost savings and high quality care,” said Capital Region BOCES Assistant Superintendent for Management Services Mark Jones. “We envision serving a group in excess of 50,000 over the next few years as this option becomes more widely known and savings are demonstrated.”

Capital Region BOCES has been awarded a Local Government Efficiency Grant through the New York State Department of State to assist with the implementation of the pharmacy initiative, which will provide further cost savings to partners during the program’s first three years. Learn more

Have to be in it to benefit

School districts and municipalities are able to join this collaborative program exclusively through the NYSMBC, which will oversee the implementation, management and development of the new Rx program in consultation with ESI and the California-based cooperative.

To get started—and to start saving—contact the NYSMBC to authorize a side-by-side cost analysis of your current plan and the new ESI plan. The evaluation of your pharmacy data and estimated savings will be completed by our consultants, Solid Benefit Guidance, Inc. (SBG), one of the nation’s leading consulting firms in the PBM industry. With more than 50 years of collective experience in this highly-complex industry, SBG provides unparalleled evaluation of pharmacy costs, performance and trends.

First enrollment in the program began July 1, 2012

School districts and municipalities do not have to alter the design of current prescription plans to participate in this new program, set to begin July 1. A rolling enrollment will be available to interested school districts that are currently under contract with employee bargaining units. We are actively conducting analysis for future dates.

To learn more about this cost-effective public sector prescription drug plan, contact us today: