Savvy advisors are challenging the status quo and differentiating themselves with new solutions to lower cost and reduce risk for their clients.

How’s your pharmacy strategy working?

  • Is it containing and reducing specialty spend for your clients?

  • Is it mitigating risk while reducing stop-loss premiums for your clients?

  • Does it maximize savings potential from the way the plan was designed?

Let us show you what you’ve been missing out on.

 

Achieved savings.

We save an average of 15-30% for our clients and are known for our multiple procurement channels, creative solutions, and passion for connecting people to improved care.

immediate savings of prescriptions
high-cost medication solutions
plan design alignment
pharmacy benefits

As a trusted partner, we harmonize pharmacy strategies by identifying multi-faceted savings to lower spend. We impact the largest component of healthcare spend with the least amount of disruption. With years of combined expertise, ASCEND greatly impacts small to mid-market employers by assisting in significant savings that benefit short and long-term strategies.

 

What is Pass-Through Pricing?

Typically, PBMs make money on inflating drug costs for profit, keeping rebates, and charging a fee to administer the benefits. We don’t agree with a traditional pricing model.

The goal should be to help members achieve a healthier well-being. That’s why we pass-through 100% of the rebate that the plan has earned through members’ prescriptions to the client.

Specialty is our expertise.

Impacting more than your bottom line, specialty medications require a greater understanding of the condition while mitigating unnecessary healthcare utilization such as urgent care and emergency services. We reduce the

 

Concierge Service, always.

We make it easy to administer prescription benefit plans. Our responsive account management delivers concierge service while our member service’s Help Desk is available 24/7 for members.

Why healthcare?

It is our goal that members receive the medicine and treatment they need to support their health and well-being while helping the plan sponsor reduce costs and mitigate risk.

That’s how we think pharmacy benefits should work.

 

Enhance your value story.

Clinical Consulting.

We are equally focused on clinical management as we are on pricing and affordability. Our reporting is designed to highlight trends, including clinical utilization while identifying medication appropriateness interventions. Our team of experts will make recommendations to help strategize your plan spend.

The key is simple: overall medical cost reduction by ensuring the most cost-appropriate, efficacious therapy is used the first time.

Assessment, development, deployment, and monitoring of interventions are all performed with one sole purpose – improving adherence and outcomes. Innovative and traditional techniques are deployed, and key metrics are followed. We innovate the industry through expert clinical solutions.

Specialty Pharmacy.

ASCEND has options to make your specialty benefit work best for your needs. Our network includes both, the largest specialty pharmacies in the U.S. and an value-based specialty pharmacy.

ASCEND’s industry-leading capabilities manage the fastest growing area of all healthcare costs - specialty pharmaceuticals and the administration of them.

While only a few patients account for the disproportionate share of total health care costs, aggressive utilization management strategies are necessary to manage these costs, including:

  • Preferred drug strategies with exclusions for both traditional and specialty medications through a nationally recognized formulary

  • Verifying products are utilized by members only where they have positive end state impact, and an enhanced option to limit utilization of new to market therapies to members who require immediate treatment

  • Promoting and monitoring adherence to the full therapy regimen for successful treatment

  • Pharmacist and nursing support to address all aspects of the member’s condition

  • Support for generic opportunities through plan design, utilization management protocols, and member conversations to increase GFR and lower specialty trend

Individual and Group Case Management.

Our Health Economics Return & Outcomes Score measures your claims-level data to impactful variables that assess the financial impact of specialty pharmaceuticals on the plan design.

Whether a single, individual case or a population group, ASCEND measures the value, outcomes, and cost of the fastest growing area of healthcare spend due to specialty medications.

Compounding.

ASCEND’s compounding strategy drives greater control of rising compound costs and utilization trends while addressing key safety, efficacy and quality risks associated with current compounding practices.

As a part of our core services, we offer a two-fold strategy to manage compounds - exclusion and PA with $300 threshold – and help address the current and future compound drug issues.

Designed to target both high-cost individual ingredients within compounds, as well as high-cost compound prescriptions, we continue to provide access for members when commercially available products are either not available at all, or not available in a dosage form that meets the need of the patient. This optional program is an optimal balance of safety, cost-efficiency, quality and accessibility of compound medications.

Mail Order Pharmacy.

ASCEND provides added convenience through home delivery of maintenance medications, refill reminders, generic incentive programs, and online access for members to manage their prescriptions.

Established, nationally-recognized regional mail pharmacies support the ASCENDpbm offering and serve as a virtual service operation across the nation with unparalleled technical & physical redundancy.

The Mail Order program fully integrates with the retail network, making the implementation seamless. We offer clients and members reduced costs, better quality and a optimal service experience.

Pharmacy Benefit Management.

We offer programs to support the unique needs of our client's and their members. Our experience ranges from self-funded employer groups, TPAs, national employers, manufacturing, education, municipal/county/state government and union sectors providing a tailored specific approach for each client.

ASCEND works hand-in-hand with our clients to design programs and pharmacy services for your population group. Dedicated Account Managers are assigned to each group after contracting to ensure a smooth implementation process throughout your plan.

The following areas are highlights of our services:

  • Implementation is key to future success. Based on past experience, the initial plan set up is crucial to long-term success and plan adjudication accuracy. We play an integral role by monitoring the entire implementation process from start to finish. We ensure clinicians are present to explain processes, eligibility and benefits are fully tested and assure the performance guarantees are met. We are available to provide information and guidance to lead the client through a thorough, timely and successful program.

  • Data and analysis make all the difference. We review claim pricing, plan design and rebates throughout the course of the year. We will deliver reports to you to demonstrate the performance of the plan. If and when we identify issues or anomalies, ASCEND will notify the client and/or broker, document back to the PBM and keep the client informed as we work through the issues in question. These processes ensure we deliver value throughout the relationship.

  • Account Management. Our involvement will be defined by the client. ASCEND will look at areas for improvement ranging from educational programs, administrative programs, benefit plan structure, dispensing avenues, and clinical aspects throughout your plan timeline to ensure optimal efficiency and plan performance.

Pharmacy Network.

Our retail network offers more than 65,000+ pharmacies nationwide including major chains, independent pharmacies, and well-known retail locations. Our PBM program combines one of the largest retail pharmacy chains in the nation with our integrated pharmacy care structure enabling us to capitalize upon multiple strengths from innovative solutions for access, engaging clinical care programs and optimizing savings.

We understand controlling costs remains a high priority for plans. Managed networks offer incremental savings or preferential pricing to support existing management strategies without sacrificing quality. With a focus on reduced drug spend, increased GFR, and overall enhanced member satisfaction, our network options offer the following:

  • 30 and 90-day strategies that reduce pharmacy spend

  • Optimize savings for both maintenance and acute medications

  • Out-of-pocket member cost savings

  • Increased medication adherence

  • Access to high-quality prescription providers

  • Customized strategies to meet state and federal regulations

  • Compounding services to reduce opioid use

  • Quality specialty services and administration

Pharmacogenetic Testing.

Personalized medicine determines the right drug and right dose for the patient the first time. Pharmacogenetic testing reveals a patient’s medication metabolism and provides specific guidance on which medications to use or avoid and the recommended dosage adjustments.

Testing eliminates waste – both, time and money – by avoiding the current ‘one size fits all’ trial and error process. Lowering adverse events, increasing clinical efficiencies while improving patient quality of life can amount to substantially lower healthcare costs. This is the healthcare industry’s leading advancement of the decade and a sound investment. ASCEND offers comprehensive, multiple labs and specific panels.

 

Wait, what is a pharmacy benefit manager?

A pharmacy benefit manager, or PBM, serves as a link between the plan sponsor (or employer), drug manufacturer, and pharmacies to help administer prescription benefits for the plan. Their primary role is to reduce pharmacy costs and help members start and stay on treatment.

PBMs have an opportunity to fix a major issue in healthcare by helping members, employers, plan sponsors, advisors, and risk managers reduce spend, mitigate costs, and improve care.

What is a pharmacy benefit strategy?

Our consultative services will help align pharmacy and medical benefits to maximize benefits and minimize spend.

At the core of ASCEND, we leverage member-driven data to enhance healthcare outcomes… and this extends to all our partners.