SBMG works successfully with a variety of customers including:
- Medium to large health insurers.
- Large employers.
- Union health and welfare plans.
- Medicaid and Medicare health plans.
- Healthcare benefit consultants.
Our program is designed to review all specialty pharmaceuticals that cost more than $250 per dose. All pre-screening and prior authorization functions are performed by SBMG’s clinical professionals.
Case Example 1: $38,320 savings to the plan
JO is a 61 yo male diagnosed with Psoriasis who has failed on Taclonex, Lidex and Dovonex. MD ordered Humira 40mg SQ qwk. SBMG recommended a treatment trial with Methotrexate and to test patient for TB. MD agreed to a trial of Methotrexate and the TB test. JO was negative for TB and the Psoriasis responded well to methotrexate and topical corticosteroids.
Case Example 2: $171,309 savings to plan
RC is a 120lb, 15 year old male hemophiliac patient. MD ordered Advate 1,300 units every 3 days for prophylaxis (bleed prevention). SBMG recommended Kogenate, a competing product to Advate, for a savings of $9,828 per year. In addition SBMG suggested using Kogenate, as needed to treat a bleed, instead of continuous use in the absence of any bleed. The MD agreed to both requests. MD prescribed two treatment cycles to be on hand for patient use in the event of a bleed. Prophylaxis cost would have been $229,341 per year. Actual treatment cost was $67,860 in the first year.
Case Example 3: $92,625 savings to plan
BD is a 35 year old female diagnosed with severe Stevens-Johnson syndrome and was ordered Acthar HP 80 units by injection every 24 hours for 3 days. SBMG spoke with MD and recommended methylprednisolone IV 250mg followed by oral Medrol tapering dose. The cost of Acthar HP therapy would have been $93,000. Methylprednisolone 250mg was $15.00/vial and methylprednisolone IV infusions $110/day for a total treatment cost of $375. The patient response was excellent.
Contact us to learn how SBMG can deliver unprecedented and immediate savings on specialty medications prescribed for your plan beneficiaries. Ask about our low/no-cost options as well!