When it comes to medication fulfillment, your employee owners and their dependents typically have multiple options between traditional retail locations, home delivery, and even specialty pharmacies when necessary. One lesser-known option is utilizing an international prescription service provider (IPSP), such as Canada-based CANARX, for brand-name drugs when a generic is not available.
CANARX, founded in 2002, was the first IPSP to introduce and supply a public sector program in America. Since then, they’ve worked with numerous partners, like us here at ProAct, to save self-funded group health plans and their members thousands each year. This completely voluntary international home delivery option not only allows ESOPs like yours to save up to 80% on brand-name drugs but does so at no cost your employee owners and their dependents.
It sounds too good to be true, doesn’t it? Let’s break down some of the most common myths surrounding international prescription service providers:
1. It is not safe.
False! You and your members’ safety are ensured. All medications are delivered in the original sealed package supplied from the brand-name manufacturer’s approved facility. The medications are dispensed and mailed directly to the member by a licensed pharmacy in a Tier 1 country, like Canada, Great Britain, New Zealand, or Ireland. What’s more, professionals regularly inspect all licensed pharmacies to ensure that all safety protocols and all American/source country regulations are met.
CANARX is fully insured for both product and professional liability. Each plan holder enjoys the added protection of being covered under the umbrella of this policy. If a medication hasn’t been approved in the U.S., it’s not on their formulary.
2. It is too complicated.
False! It is as easy as enrolling in the program to take advantage of the convenience and savings. Once a member is considered treatment-experienced with their maintenance medication, they are ready to begin using an IPSP.
With CANARX’s program, members pay $0 in copays and, instead of waiting in line at the pharmacy, the medications are shipped right to their door for free. After they use the program for the first time, they have nothing else to do because CANARX will continue to proactively support their refill needs. Members can revert back to purchasing their medications at a local pharmacy or mail order provider at any time.
3. It just sounds too good to be true.
Savings are a result of what is known as “Single Payer Healthcare”. In this model, governments negotiate pricing with each pharmaceutical supplier guaranteeing the lowest cost possible. IPSPs like CANARX’s source countries employ this model. In the United States, pharmaceutical providers are free to set their own prices which typically results in much higher prices.
We recommend anyone exploring personal importation through an IPSP ask the following …
- Are they insured and am I covered under this policy?
- How long have they been in operation?
- What medications are offered, what countries are they provided from, how are they packaged and how are they shipped?
- What is the average savings provided to the plan and member?
- What types of reporting are available?
- Are their claims acceptable for stop-loss purposes?
- Are they HIPAA compliant?
- Is their program subject to ERISA?
- How long have they been in business for and has the company followed the same program overview and safety protocols throughout?
We hope this helps take some of the mystery out of international prescription fulfillment. While there is no magic bullet to lowering employee health costs, utilizing an IPSP may be an option in an overall savings strategy for self-funded groups.
As TEA’s Pharmacy Benefit Management partner, we’d love to tell you more about cost-mitigating strategies like this one. Contact us today to learn more: TEAPBM@proactrx.com.
As a Strategic Partner for Employee Owned 2021 ProAct was invited to submit a post to The ESOP Association Blog. If you are interested in sponsoring an event or submitting a blog post, please contact TEA.