With patients screaming more than ever about the high cost of prescription drugs, an Indianapolis company thinks it has the right solution to ease the pain.
Rx Help Centers helps workers who can’t afford their prescription drugs obtain massive discounts by navigating the labyrinth of drugmakers’ discount programs, charitable-foundation funding and mail-order pharmacy discounts.
Most of the programs are available to patients on their own, but they are often hard for patients to find.
Since shifting its sales focus from individuals to employers in January, Rx Help Centers has signed up 46 Indiana employers and is helping 560 people on their health plans. More are committed to join in the next few months.
The company, which has only eight employees at its office near the Pyramids, expects to have 25 by year end, 100 by the end of next year, and more than 250 by the end of 2017.
“I wish I could be more specific, but this is a rocket ship I’ve yet to ride, so far,” said Jeff Christensen, Rx Help Centers’ 34-year-old president. Clad in jeans and a baseball cap, Christensen described himself as a “wrench turner” who never expected to be in this kind of business.
Rx Help Centers is pulling in $28,000 a month from employers by charging them $50 per month for each person on the company health plan it helps. But those employers and their workers are saving more than $1 million per month, Christensen said.
Cici Hendrix, human resources director at the city of Fishers, said the Rx Help Centers pitch was hard to believe when she heard it early this year.
“Probably like a lot of people’s initial reaction, it sounded too good to be true,” she said. “But after learning more about it, it was an easy decision.”
Since April, the city has paid for Rx Help’s service for 31 people on its health plan with high prescription drug spending.
Rx Help so far is saving Fishers $104,000 per month, Hendrix said. Fishers spent more than $1.5 million on prescription drugs last year.
Hendrix said most of the savings is coming from having one of its workers get a drug for free that was costing $70,000 a month.
There are more drugs with those kinds of price tags on the market than ever before. Drugs such as Sovaldi and Harvoni that are curing hepatitis C for some patients, and new oncology drugs such as Yervoy, Keytruda and Opdivo that are achieving results never before seen in cancer patients.
But those drugs can cost $80,000 to $150,000 for a standard course of treatment.
And drugmakers have more of those types of drugs in the final stages of development. A 2014 report by UnitedHealthcare projected that spending on these so-called specialty drugs would surge from $87 billion in 2012 to $400 billion in 2020.
Jim Jorgenson, CEO of Minnesota-based pharmacy consulting firm Visante Inc., noted that, even before the coming wave of new drugs, specialty medicines accounted for about 1 percent of all prescriptions but 30 percent of prescription-drug spending.
“The story is only getting worse,” he said.
Other companies offer services similar to those of Rx Help Centers. OneRx.com and WeRx.org are two that Paul Ashley, vice president of sales at First Person benefits consulting firm, recommends to his employer clients.
And he expects to see more.
“Just like it’s the tip of the iceberg for this type of [specialty] medications, it’s also the tip of the iceberg for these types of companies,” Ashley said.
He used the OneRx mobile app to find cheaper prices for the ADD medicines his two children take. That has saved him $400 a month.
“There’s actually lots of money out there for people who know where to go and who to ask,” said Bill Stafford, vice president of marketing at Rx Help Centers.
Christensen and Anji Hopper, who co-founded Rx Help Centers, gained their knowledge by happenstance while trying to sell short-term medical insurance for a company called US Insurance Help Centers, starting in 2006.
They found that one of every four people who inquired about buying coverage couldn’t afford it due to high prescription-drug costs. Hopper and Christensen started trying to figure out ways to save money on medicines, so their prospects could buy insurance. That resulted in starting Rx Help Centers in 2009.
But after the passage of the Affordable Care Act in 2010, Christensen said, people stopped buying short-term medical insurance. So the following year, Christensen and Hopper focused exclusively on helping patients reduce their medication expenses.
They gained contacts at drug manufacturers whom they could call instead of working through drugmakers’ standard patient-assistance programs. Those programs are designed for only the poorest patients, rejecting four of every five applications.
Christensen and Hopper also built up contacts at private foundations interested in keeping patients compliant with their medications—since doing so is one of the surest ways to avoid larger health care bills later. And they got smart about mail-order pharmacies that gave access to wholesale prices and even prices from non-U.S. markets.
They built up a team of 17 independent advocates that work with patients. So far, they have served nearly 9,000 patients.
But that business wasn’t making much money. Rx Help Centers priced its service for individuals too low, causing many patients not to trust it to be legitimate. Christensen supported himself doing handyman work during the lean times.
“I had all but given up on the idea until I met Bill [Stafford],” Christensen said.
Stafford, a veteran insurance salesman and former head of benefits surveys conducted by Indianapolis-based United Benefit Advisors, told the struggling company scads of employers would be interested in its service.
“I thought, ‘This is something that is huge,’” Stafford said.
Todd Foushee, CEO of On-Target Health, which helps patients get off medications through an obesity-reversal program, thought the same. His company has teamed with Rx Help Centers to make joint sales calls to employers. Rx Help Centers can produce quick savings, then On-Target can help patients get off some medications entirely, permanently reducing employers’ health care spending.
“We’re both trying to get to the same goal by improving health outcomes,” Foushee said. “It’s a combination of all of these things that will help us solve these problems.”•