Artemetrx data and analytics platform integrates medical and pharmacy data to deliver immediate, actionable drug cost savings opportunities – needed now more than ever
PLANO, Tex. – Artemetrx is partnering with Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in Missouri, to help its member plans manage rapidly-rising drug costs across medical and pharmacy benefits.
“The Artemetrx platform is currently providing actionable drug cost savings insights to dozens of Blue Plans and other insurers, resulting in $4.8 billion in identified savings for plan sponsors in 2019,” said Michael Lonergan, President of Artemetrx. “We are so proud to be partnering with Blue KC to identify new savings opportunities for their plan sponsors.”
“Our goal is to help plan sponsors eliminate every dollar of waste in their drug spend so they can focus on the lifesaving, innovative drug therapies that make a real difference for their members,” said Chad Moore, Vice President, Strategic Partnerships & Network Operations at Blue Cross and Blue Shield of Kansas City. “After a trial of Artemetrx showed us significant savings opportunities that were otherwise hidden in our data, we immediately saw the value and knew our plan sponsors could benefit.”
Drug costs for payers continue to rise. Based on the annual State of Specialty Spend and Trend Report, powered by Artemetrx data, specialty spend across the pharmacy and medical benefit increased by 13.6% in 2019. This trend is driven by both increases in cost per claim and overall utilization, 3.3% and 10.3% respectively.
As health plans and plan sponsors become responsible for an increasingly sizable pharmacy investment, they continue to look for new ways to ensure their drug spend is optimized.
“We like to say that the most expensive drug is the one that’s not needed,” said Lonergan. “And Artemetrx is designed to identify those that are not. The reasons are varied: from instances of fraud to duplicate prescriptions on both medical and pharmacy benefits to drugs with questionable clinical effectiveness compared to less expensive therapies.” Artemetrx relies upon a robust dataset and a team of clinical pharmacists, data gurus and fraud, waste and abuse experts to help plans identify where drug spend is being wasted. The user-friendly, web-based tool is dynamic in that it analyzes drug use, costs and trends over time, by population or by individual. It also shows cost and use breakdown by provider, therapeutic category, drug or site of care to reveal opportunities for cost efficiencies. In addition, Artemetrx can identify top drugs by spend and by category and compare against benchmarks based on patient population or health plan size.
“Whether drugs are paid on the medical or pharmacy benefit, what’s important is the total impact to the plan,” said Moore. “Artemetrx allows plan sponsors an integrated view of both medical and pharmacy drug spend to illuminate trends and outliers that aren’t obvious. This data-driven approach allows us to help plan sponsors take action to control costs or stop a brewing problem – before an anomaly becomes a million-dollar headache.”
The Artemetrx team continually expands the rule sets and logic within the system to reflect the latest clinical best practices and lessons learned. In addition, they employ machine learning to keep plan sponsors a step ahead of predicted opportunities for fraud and waste.
Artemetrx is a robust integrated data and analytics platform that transforms member data into actionable intelligence, driving improved management of drug spend and trend across both pharmacy and medical benefits. Artemetrx precisely and efficiently identifies suboptimal utilization of prescription drugs from multiple angles, such as member, prescriber, or drug. Built on more than 20 years of drug management expertise, the web-based platform provides users with reports, dashboards, and multidimensional filtering and dynamic drill-down capabilities, enabling efficiency, precision, and scalability for drug management.