Navitus Health Solutions: A Winning Formula 

City of Kenosha Continues to Control Pharmacy Spend

In 2018, the city of Kenosha, Wisconsin (with 900 employees and approximately 2,400 plan members) looked to replace its existing pharmacy benefits manager due to unsustainable cost increases. The city implemented BHCG’s best in class strategic partner Navitus Health Solutions on January 1, 2019, taking advantage of BHCG’s preferred contract rates and terms – and the results have been outstanding.

• In the first five years with Navitus as its pharmacy benefit manager, the City has saved more than $4.2 million.
• Five times more rebate dollars secured in 2023 compared to 2018 due to Navitus’ 100% pass-through of rebates and pharmacy discounts.
• Net plan cost Per Member Per Month (PMPM) decreased by 37% from 2018 to 2023.
• Due to Navitus’ clinically driven formulary management, 17% average reduction in total plan costs (before rebates).

Other BHCG member employers implementing Navitus are experiencing comparable results. To learn more about how your organization can gain control over your pharmacy spend, contact BHCG Executive Director Jeffrey Kluever at 262-875-3312 X1 or jkluever@bhcgwi.org.

Aggregate BHCG Member Employer Navitus Results Strong Again in 2023

BHCG member employers saw a similar strong performance from Navitus in managing their pharmacy benefits in 2023:

• In aggregate, member employers had a Net Total Plan Paid PMPM increase of 5.3%
• Thirty-eight percent of member employers had a negative trend from 2022 to 2023
• Member employers spent an average of $64.56 PMPM on pharmacy benefits with their previous PBMs in 2018. These same clients paid $65.06 in 2023 (less than a 1% increase) in Net Plan Cost PMPM over the course of five years.
• In aggregate, member employers received over $13 million in rebates in 2023. Through the 100% pass-through model, this is $1 million+ more than if contracts were limited to guaranteed rebate amounts. 

2023 Navitus Drug Trend Report Highlights

Navitus Health Solutions recently released their 2023 Drug Trend Report. As in past years, the 2023 report demonstrates how Navitus is outperforming the PBM industry on several key metrics for all its clients:

• Commercial clients saw a 6.8% average increase in Net Total Cost¹ PMPM trend from 2022 to 2023.
• Despite notable increases in unit cost and utilization, 29% of Navitus commercial clients saw their net drug spend decrease compared to 2022.
• Decreased unit costs (-4.9%) helped to manage total specialty trend to a modest 5.7% PMPM increase for commercial clients as utilization trend increased more than 10%.
• New clients saw an average 11% reduction in Rx costs compared to the previous year with a different PBM.

The 2023 Navitus Health Solutions Drug Trend Report Executive Summary is available for review.

¹Net total cost includes total cost paid by plans and members minus manufacturer rebates