Cost-Effectiveness Redefined
Cost Savings
We can help health plans reduce specialty drug costs by over 90% without changing benefits or limiting access to care.
Our carve-out solution integrates seamlessly with your existing formulary and combines scientifically de-risked IVPE programs with a guaranteed cost-containment model – delivering immediate savings and long-term cost reduction with clinical validation of low-cost therapies.
How Our Cost-Savings Model Works
Built to reduce cost without disrupting members
Step 1
Voluntary and safe
Members opt in to trials of safe, lower-cost alternatives .
- Participation is always voluntary
- Nothing changes without patient consent
- Enhanced clinical monitoring throughout
Step 2
Savings from day one
Your plan saves the moment a member enrolls.
- Plans pay about 80% of current cost
- Around 20% saved per enrolled member
- Savings apply regardless of outcome
Step 3
Long-term cost reduction
Validated therapies unlock far lower pricing.
- Over 90% savings possible versus current drugs
- Durable impact on pharmacy spend
- Evidence supports formulary decisions
Step 4
Seamless integration
The program runs alongside your existing plan.
- No change to your benefits structure
- Minimal operational lift to launch
- No disruption for patients or providers
Why Choose PGP’s Carve-Out Solution?
A practical way to reduce specialty drug spend without disrupting care
Guaranteed savings from day one
Health plans save approximately 20% per enrolled member during the trial, reducing financial pressure without limiting access to treatment.
Long-term return on investment
Once a lower-cost therapy is clinically validated and/or approved by the FDA, savings can exceed 90% compared to the original specialty drug.
Better formulary decisions through real evidence
Clinical trial data supports formulary strategy and strengthens negotiation leverage with manufacturers.
Seamless plan integration
Designed to work within existing pharmacy benefits structures, with no disruption to members or providers
Example Use Case: Ketamine vs. Esketamine
Treatment-Resistant Depression
- Current drug: Esketamine (Spravato)
- Current cost: ~$12,000 for a 3-month induction / $22,000+ annually per patient
- Market impact: Payers are spending over $2B annually
- PGP trial cost: ~$10,000 per enrolled patient (3-month trial using synthetic control)
- Immediate savings: ~20% per enrolled patient during the trial
- Proposed alternative: Ketamine
- Estimated cost post-approval: <$1,000 annually
- Potential long-term savings:
- $20,000 per patient annually
- 90%+ cost reduction vs. esketamine
Comparative Analysis
Ketamine vs. Esketamine: A Use Case in Efficiency
Our analysis and literature review reveals significant cost disparities and likely clinical superiority of pharmaceutical-grade IV generic ketamine over branded Esketamine (Spravato). With IVPE trials, you can achieve superior fiscal outcomes, while also helping generate the high-quality clinical evidence required to support FDA approval.
Standard Branded Cost
$22,000 / year
PGP Optimized Cost
<$1000 / year
Partner with Public Good Pharma
Our IVPE programs offer self-insured employers a compliant and forward-thinking solution to specialty drug cost management, legal risk mitigation, and better healthcare outcomes. Contact Us Today to learn how we can support your compliance and cost-saving goals.