Prescription Drug Solutions

Save Money On Your Employee Prescription Drug Program

As a part of our efforts to reduce health care costs, Walmart has introduced a new program for self-insured employers and health plans that allow these organizations to reduce the amount they pay for their employees’ and members’ prescription drug benefits when they use Walmart, Sam’s Club or Neighborhood Market pharmacies.

Claims analyses show that employers could save as much as 35 percent or more on generic drugs under this program. And since generics make up about 2/3rds of all prescriptions filled, that can quickly add up to a lot of savings. Savings on brand name drugs can also be realized.

How it Works

It’s simple. Walmart buys and distributes prescription drugs very efficiently. This program allows us to pass these savings along to self-insured employers and health plans. Your PBM may continue to process and adjudicate all claims.

The employer or health plan then modifies its plan design to encourage plan participants to use Walmart pharmacies – for example, by having a co-pay on generic drugs that is $5 less at Walmart than at other pharmacies. The more your employees or members use Walmart pharmacies, the more you save.

It’s a quick and simple way to implement consumer driven healthcare for prescription drugs. The employer saves money. Their employees save money. And you don’t need to change your network and take away choice.

Implementation

The program is very simple to implement and requires no additional resources by employers. Claims processing and adjudication may continue to be handled by the employer’s current PBM or the PBM of their choice.

Implementation steps are as follows:

Calculate Savings Opportunity – Walmart analyzes your most recent three months of de-identified claims data to identify potential savings opportunities for your organization.
Contract – A contract between Walmart and the employer will address Walmart's commitment to provide transparent, cost-plus pricing and the employer's responsibility to provide incentives for its employees to use lower-cost Walmart pharmacies.
Plan Design – The employer modifies or adds an option to its existing plan design. For example, set up a $5 co-pay differential on generics between Walmart and other pharmacies.
Employee Communications – The employer communicates the plan design change to employees or members.
Price Lists – Walmart provides monthly price list to the plan’s PBM to load into its system.

A word on pricing

To help employers save money on prescription drug costs through this program, Walmart leverages its purchasing and distribution efficiencies and passes these savings along to employers. Cost-plus pricing is used to make pricing more transparent to employers. It’s all a part of our commitment to help our customers save money so they can live better.

Frequently asked questions

Why is Walmart doing this?

Walmart is committed to reducing the cost of health care. By purchasing prescription drugs at a discount and distributing them efficiently, Walmart is able to pass through savings along to employers who can then incentivize their employees to use lower-cost Walmart, Sam’s Club and Neighborhood Market pharmacies. The more your employees use Walmart pharmacies, the more you save.

Who is this program for?

Walmart’s program is for all employers or health plans that have self-insured their prescription drug benefit.

How does my company benefit?

Your company benefits by spending less on prescription drugs for your employee benefit plan. Your employees benefit as well when you incentivize them to use lower cost Walmart pharmacies through reduced co-pays. And, you don’t need to remove choice. Your employees can continue to use the pharmacy of their choice, but they will only receive the lower co-pay at Walmart pharmacies.

Are their benefits other than discounted price?

Yes. Keeping drug prices low mean it’s less likely that patients will skip doses or wait between refills, which can result in improved health outcomes and lower long-term health costs. With Walmart’s pricing, co-pays can remain reasonable and we can help keep health care more affordable. Plan members will have access to highly trained Walmart pharmacists who provide counseling and answer any questions they may have.

What if my company doesn’t have co-pays?

That’s fine. If you use co-insurance or another type of plan design instead of co-pays, this program may work for you also..

Will this affect my mail order drug program?

If you have a mail order drug program now, Walmart can conduct a savings analysis to identify potential savings for that program. Then, you can decide if you want to offer the program to your employees that use mail order. In addition, any of your plan participants are eligible to use Walmart’s ship to home mail program and pay the same price they would at Walmart retail pharmacies.

Can my PBM administer this program?

Yes. Walmart provides a monthly price list to be loaded into its system. When your employee uses a Walmart pharmacy, the employer is charged the reduced amount and your employee is charged their lower Walmart co-pay amount.

How do I calculate the cost savings opportunity for my company?

It’s simple. Just provide Walmart with the de-identified data from your most recent three months of claims. We’ll overlay Walmart program pricing and show you how much you would have paid under Walmart’s program. Also, include a copy of your Benefit Plan Design and Walmart will calculate the savings to you and your employees based on different co-pay amounts. Call 877-234-8662 or fill out our contact us form to be contacted by an Account Manager who can explain the process and answer any questions you may have.

The following data is needed (most recent 3 months) in order to calculate potential cost savings for your organization:

Individual Claims Data: