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. 100% Voluntary Participation, Personalised Oversight & Informed Consent:

    • Members voluntarily enroll in clinical programs designed to test lower-cost alternatives to high-cost specialty drugs.
    • Trials are designed to maximise likelihood of better outcomes with the lower cost alternative vs standard of care, including use of biomarkers to enable personalised treatment.

    • All trial participants receive compensation, medical insurance coverage, and enhanced monitoring by our CRO partners during the program, always subject to informed consent and ethics committee oversight in accordance with applicable law. 

  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 with >90% discount possible 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 are possible post-Trial, to 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 / $22,000+ per patient annually, where payers are being charged over $2b 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 (<$1,000 annually).

  • Potential Savings: >$20,000 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.