HealthPlan Data Solutions LLC (HDS) was established in 2010 by a team of pharmacists, business executives and software development professionals who believe that the current approaches being used to contain healthcare cost in the area of pharmacy benefits are flawed. Our pharmacists have over 40 years of combined experience in hospital, retail, and academic practice.
The prescription benefit market has evolved in a way that has permitted key stakeholders and providers to take advantage of employers and consumers. Pharmacy benefit managers (PBMs) have been given almost exclusive control of information and use the lack of transparency to increase their profits at the expense of employers and employees. Drug companies spend millions to extend their patents by developing slightly modified forms of medications. These modified medications provide the same or similar outcomes as their predecessor, but at a higher price. Employers spend at least 25% more on their prescription benefits every year than is necessary.
HDS is a company that cuts through the confusion to generate savings in the healthcare system. We know the industry and how to save money through informed decisions and empowering you to control these costs. We offer solutions that don't disrupt your operations and are simple to implement. You run your business; we'll handle your prescription problems.
Our specialty is pharmacy benefits. Self-funded companies are overpaying for prescription medications. Conservative estimates put the overpayment at 30% and possibly as high as 50%. Our software and pharmacy specialists identify waste and overpayment. Our revenue model is designed to insure that "We only make money when you save money."
The total cost of healthcare in US in 2008 was $2.3 trillion of that $234 billion was spent on medications. Prescriptions costs represent approximately 10% of the total healthcare bill. Inflation of medication prices continues to outpace overall inflation. While overall Inflation of medication prices has slowed since 2001, name brand medication prices continue to increase at over 9% per year.
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We would have statins in our water much like fluoride if it was left up to the medical complex in America. While I believe you should only make changes in your medication therapy after discussions wi
Our software was developed by pharmacists and programmers to deliver the unique knowledge of
pharmacists to employers and their employees. HDS Spotlight™ gives you a transparent look
into prescription pricing and therapeutic alternatives, things some participants in the distribution
channels may want to keep from you. HDS has 12 reports to do the initial analysis of your
prescriptions data, and then a growing list of reports to help in the ongoing monitoring of
your prescription benefit plan.
Each person covered in the prescription benefit plan who takes medications, will receive a personal
medication Savings Report. This report will list each medication the patient has received in the
previous 12 months, and show them how they can save money in the future by following our recommendations.
The report will show therapeutic alternatives with the equivalent strength and frequency for the suggestion.
Other recommendations may be as simple as getting a 90 day supply or choosing an alternate provider for
The patient receives a Patient Letter describing our Savings Report and the process we would like them to
follow. They also receive a Physician's Letter that explains our report, the process, and the rationale behind
our substitutions to the doctor. All of these are intended to be taken by the patient to their next physician
The Savings Reports and letters can be picked up by the patient at our secure web portal or can be sent
through the company's communication system already in place within their operations. HIPPA regulations must
be followed in the distribution of this information.
Once contracted with the client, HDS provides ongoing monitoring of their pharmacy data. This equips the client
to assure their savings are maintained through real time or monthly reporting that includes actionable data.
Some examples of actionable data include:
Formulary tiers are a strategy of PBMs to maximize their rebates. There are other ways to determine
the price of prescriptions. HDS will work within the established tier structure your contract mandates,
and over time will show you a better way to set prescription co-pays through transparency. All your
medications should be evaluated based on the average cost share percentage that the member is paying.
Don't let your PBM claim that alterations to a drug's tier will significantly affect your rebates. The
savings will more than offset this argument.