Integrated Health Management

One of the largest areas of financial concern for employer sponsored health plans is branded and specialty medications. Often less than 10% of the people on a plan account for almost 50% of the medication cost due to the high price of the medications required for their conditions. In addition, many patients are paying high copay or coinsurance rates on these medications in addition to the employer spend.

MakoRx has developed a program to off-set these high prescription costs and eliminate any out-of-pocket cost for the patient. Our Integrated Health Management program or IHM, utilizes 340b pharmacy pricing to dramatically lower the cost of certain medications. Our IHM program capitates cost by bundling care and medication into one fixed monthly price per employee.

MakoRx through our partner, a non-profit healthcare entity, has access to 340b pharmacy pricing which is deeply discounted medication costs for employers. Our program ensures that qualifying patients receive their medications for $0 cost and the employer benefits from all of the medication savings. This program does not require any income stipulations for patients to receive the discount and all medications are sourced in the United States.

Most patient administered medications are part of the program with the exception of controlled substances and medically administered drugs. Not every medication has a 340b price, but if it does, MakoRx will provide an upfront all-inclusive price to employers with no additional admin fees or other patient costs. Employers are only invoiced for patients actively enrolled. Some popular medications we cover with 340b are Humira, Dupixent, Cosentyx, Cimzia, Trikafta, Stelara, Ozempic, Mounjaro and more.

Through our Integrated Health Management 340b program, MakoRx can save an employer between 20% and 50% of their total Rx spend for the year. More importantly, patients never pay anything for their medications on this program providing them with important access to lifesaving medications for free. We provide concrete cost analysis for the existing plan spend versus our IHM pricing and will show an employer exactly what their savings will be based on their data.

One of the most prevalent and costly conditions on any health plan is diabetes. Between the popularity of GLP-1 medications like Ozempic® or Mounjaro® and the cost of branded drugs and insulins, employers can significantly reduce health costs associated with diabetes by moving to a bundled care model. Most patients with diabetes take more than one branded medication, so by bundling all their medication costs into a standard capitated monthly payment, savings are recognized by utilizing both 340b pricing, grouping medications, clinical pharmacy care and testing supplies into a bundled price.