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Examining the case for direct contracting: A multistakeholder case study.

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    Direct contracts for prescription drug payments can save employers and employees money. This study found that direct contracting offers financial benefits and more transparent pricing for employers and pharmacies.

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    Area of Science:

    • Health economics
    • Pharmacy management
    • Healthcare policy

    Background:

    • Prescription payment systems present challenges for employers and pharmacies.
    • Direct contracting models for prescriptions and bundled services show potential benefits.

    Purpose of the Study:

    • Explore direct contracting through multistakeholder interviews.
    • Compare employer/employee prescription costs under PBM vs. direct contract.
    • Project pharmacy financial outcomes under a direct contract.
    • Assess employee satisfaction with direct contracting.

    Main Methods:

    • Semistructured interviews with stakeholders.
    • Analysis of employer PBM invoices for 412 prescriptions over 6 months.
    • Financial projections for direct contract scenarios.
    • Descriptive analysis of employee satisfaction survey data.

    Main Results:

    • Stakeholder interviews highlighted benefits and challenges of direct contracts.
    • Financial analysis indicated potential savings of $5,664 for employers and $1,918 for employees.
    • Projected pharmacy profit under the direct contract was $899.
    • Employees reported general satisfaction, with limited use of bundled services.

    Conclusions:

    • Direct contracting can be financially advantageous for employers, pharmacies, and employees.
    • This model may provide greater pricing transparency.
    • Increased utilization of bundled services could enhance employer value.