Transforming Specialty Drug Spending

At Public Good Pharma, we offer a specialty drug carve-out solution that integrates seamlessly with your health plan formulary to deliver significant cost savings while maintaining patient access to life-saving therapies. Our unique approach combines Interventional Pharmacoeconomics (IVPE) clinical trials with a guaranteed cost-containment strategy.

How Our Cost-Savings Model Works

  1. Voluntary Participation:
    • Members voluntarily enroll in clinical programs designed to test lower-cost alternatives to high-cost specialty drugs.
    • All trial participants receive compensation, medical insurance coverage, and enhanced monitoring during the program and can withdraw anytime.
  2. Cost-Savings During the Trial:
    • PGP charges ~80% of the specialty drug cost for the duration of the trial, guaranteeing immediate 20% savings per member enrolled, regardless of trial outcomes.
    • For example, if a specialty drug costs $100,000 annually, PGP charges only $80,000 per patient during the trial.
  3. Long-Term Savings Post-FDA Approval:
    • Once the lower-cost therapy is validated and FDA-approved, health plans gain access to the new therapy at a ~90% discount compared to the original specialty drug.
  4. Integration with Your Formulary:
    • Our program integrates seamlessly with your formulary as a carve-out solution, requiring minimal operational changes. Patients and providers experience no disruption in accessing care.

Why Choose PGP’s Carve-Out Solution?

  • Guaranteed Savings: Upfront 20% savings per enrolled member, reducing financial pressure without compromising care.
  • Long-Term ROI: Over 90% cost reductions post-FDA-approval ensure sustainable savings for your health plan.
  • Data-Driven Decisions: Access to clinical trial data supports formulary decisions and enhances negotiation power with manufacturers.
  • Seamless Integration: Designed to complement existing pharmacy benefits structures with no disruption to members.

Example Use Case: Ketamine vs. Esketamine

  • Drug: Esketamine (Spravato) for Treatment-Resistant Depression.
  • Current Cost: $12,000 for 3 month induction / $25,000 annually. 
  • PGP Trial Cost: $10,000 per enrolled patient trialing ketamine vs esketamine synthetic control arm for 3 month induction (~20% savings during the trial).
  • Validated Alternative: Ketamine (off-label use, <$1,000 annually).
  • Potential Savings: $24,000 per patient annually post-FDA-approval (>90% discount compared to esketamine).

Ready to explore how Public Good Pharma can reduce your specialty drug spending while advancing healthcare innovation? Contact Us Today for a tailored proposal.