Contract covers approximately 720,000 State employees, dependents and retirees
NEW YORK, August 7th, 2017 – The outcome of a contract between Truveris and the State of New Jersey to assist with reducing the State’s prescription drug spend will result in a savings of approximately 18% on a new three-year contract with OptumRx.
New Jersey becomes the first state government to use Truveris’ technology platform across multiple employee populations. The cooperation between the legislature, unions and the State on behalf of the taxpayers of New Jersey was essential in opening up an enormous opportunity for costs savings on the prescription drug program.
More than 300 employers ranging from small- to medium-sized businesses and local labor unions to large, multi-national corporations with more than 50,000 employees are saving money through the Truveris TruBid platform. Truveris technology has helped negotiate coverage for nearly 7 million people and has influenced more than $9 billion of pharmaceutical spend.
“This was an amazing coalition that worked together on a number of levels to achieve unprecedented results for everyone in New Jersey,” said Faisal Mushtaq, Truveris President and CEO. “New Jersey has multiple contracts which made the challenge even greater, but this was not a unique situation for Truveris, our technology delivered across the State’s multiple benefit plans, demonstrating the versatility and scalability of our team and our platform.”
According to Mark Blum, Executive Director of America’s Agenda, the contract and its results presented a major paradigm shift for elected state leaders and public worker unions. Blum’s organization is the non-profit health care coalition and think tank that proposed the strategy and worked closely with New Jersey public employee unions and elected officials to carry it out.
“This is an amazing result from a unique and innovative practice that is enabling us to realize continued savings without any additional costs to public employees,” said New Jersey State Senator Steve Sweeney, who worked on the initiative in partnership with the public employee unions, government officials and America’s Agenda.
New Jersey Education Association Director of Research and Economic Services Kevin Kelleher helped convince the State to implement a more competitive bidding process. “By using technology to compare the drug pricing of each vendor at a very granular level, we were able to make an apples-to-apples comparison and become an informed purchaser,” Kelleher explained.
How Truveris technology is helping New Jersey save $1.6 Billion
The State has historically spent approximately $2.2 billion annually to provide prescription drug benefits to employees, dependents and retirees of the School Employees Health Benefits Plan, the State Health Benefits Plan, and the Employer Group Waiver Plans (EGWP).
The new contract will result in a total three-year savings of nearly $1.6 billion. To achieve this, Truveris helped the State conduct a reverse auction that included three pharmacy benefits managers (PBMs). In the reverse auction, the bidders were provided with historical data on nearly 11 million prescriptions that were covered by the State in 2016. During two rounds of blind bidding, the PBMs offered their best prices for the State’s three-year contract. The Truveris technology platform priced the proposals utilizing code-based classification of drugs from nationally-accepted data sources.
Traditionally, the vendor selection process can take more than six months. By leveraging Truveris’ technology platform, the State concluded the entire process in less than two months.
Ongoing Bill Review Helps Ensure Compliance
After the new contract is implemented, Truveris will apply its ongoing Bill Review solution for the first year of the contract to help ensure that OptumRx is delivering on its contractual commitments to the State. “Using the Bill Review process, we will be able to monitor bills on an ongoing basis. This will ensure that we don’t experience unexpected cost overruns after the contract starts,” said Kelleher.
Bill Review is the first independent claims adjudication platform to validate and ensure financial accuracy, based on contract terms and definitions, of 100% of pharmacy claims on a vendor’s invoice. All the reporting and analytics features are delivered through a secure portal which has the capacity to receive and process all pharmacy data and re-adjudicate each individual claim to identify contract variance instantaneously.
Truveris brings transparency to the prescription drug ecosystem through data-driven innovations. Truveris’ platform offers customers – from the individual patient to employers to retailers to pharmacy benefits stakeholders and manufacturers – the data and insights they need to effectively and efficiently manage rising costs and market access strategies.