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PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing Cost Containment SimpleSaveRx TM Solutions & Services Overview

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Page 1: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

PHARMACY BENEFITS

the Right Way

Pure Pass-Thru Pricing

Cost Containment

SimpleSaveRxTM

Solutions & Services Overview

Page 2: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

Purchase Rx’s at the Pharmacy Best Pricing as Pharmacies compete to win your business

Contribution model and analytics provide ability to control Rx spend

Employers and members become informed consumers by using the Simple$ave app

Information for Better Outcomes

Contain Cost & Control Budget

Pure Pass-Thru Pricing

2SimpleSaveRx All Rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

SIMPLESAVERX BRINGS VALUEOpen Honest Options

Page 3: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

$2.32 $2.65$4.25

$3.30$5.35

$2.56

$7.68 $7.35$5.75

$6.70$4.65

$7.44

$0.00

$2.00

$4.00

$6.00

$8.00

$10.00

$12.00

Pharmacy 1 Pharmacy 2 Pharmacy 3 Pharmacy 4 Pharmacy 5 Pharmacy 6

Savings

Pharm2U

3SimpleSaveRxTM All Rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

PASS-THRU PRICING & SAVINGS IS HEREPass-Thru Pricing Transforms the PBM’s Profits into Plan Savings

$9.54 Total Price

Pure Pass-thru Pricing eliminates

Spread

SSRx enlists the Pharmacies to provide “Pharm2U” drug prices. Providing True Pass-Thru Price to You.

Ex. Generic – Hydrocodone/Acetaminophen (Vicodin) 10mg/325mg

Everything in Green is NOW Your SAVINGS

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4SimpleSaveRxTM All Rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

HOW DOES CONTRIBUTION WORK?Changing the Equation to Set Your Budget

$5.00 $5.00 $5.00 $5.00 $5.00 $5.00

$1.83$2.95

$6.50

$3.46

$5.35$4.52

$0.00

$2.00

$4.00

$6.00

$8.00

$10.00

$12.00

$14.00

Pharm 1$6.83

Pharm 2$7.95

Pharm 3$11.5

Pharm 3$8.46

Pharm 4$10.35

Pharm 5$9.52

Member$OOP

SponsorContribution

Drug falls into Tier 1 ($0 - $20) Employer Contributes $5.00 for any drugs in Tier Based on Historic Claims data or Industry Avg.

SSRx app creates data models to predict budget

Atorvastatin-Calcium (Lipitor) 20mg 30 count

Employers Determine Amount to Contribute

per Tier

..Simplifying Budgeting

Plan design will establish how the savings are split between the Employer and Employee

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5SimpleSaveRx All Rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

PHARMACY CONTRIBUTION MANAGEMENT MODELSimple Tiered Model for Employer Contributions (no complex Formulary)

Tier Low High Avg. Cost

% of Rx's Written

Suggested Contribution

EmployerContribution

Employee Expense

Monthly Contribution

Tier 1 $0 $20 $4.25 38.50% 50.00% $ 10.00 $ 0.00 $ 4,427.50

Tier 2 $21 $50 $38.24 29.25% 60.00% $ 30.00 $ 8.24 $ 10,091.25

Tier 3 $51 $100 $86.58 18.56% 50.00% $ 50.00 $ 36.58 $ 10,672.00

Tier 4 $101 $300 $207.20 10.65% 50.00% $ 150.00 $ 57.20 $ 18,371.25

Tier 5 $301 … $2,765.00 3.04% 20.00% $1,000.00 $ 1,765.00 $ 34,960.00

Tier 1

Tier 2

Tier 3

Tier 4

Tier 5

• Employers set the amount that they will contribute by % or $ for all drugs in a Tier

• Tiers cover all drugs within their range

• Historical claims analysis is used to help project budget

50%

60%

50%

50%

20%

# of Employees 500

Rx/Mem/Mo 1

Avg. Dependents/ Emp 2.3

Total Members 1150

~Annual Contribution $405,669.41

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SimpleSaveRx All rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

Estimated Rx Program Savings

All data presented here is based on Insurance Industry Standards or come from 2012-13 Economic Report on Pharmacies & Prescription Drug Benefit Cost and Plan Design Report 2012-2013 Edition sponsored by the PBMI.

Discounts

Rebates

Consulting Fee

Benefit Service Fee

Pass Thru-Pricing

Additional Cost Savings

Premier Network

SERVICE BENEFITS & RETURNSPCM Employer and Employee Savings Over Time

6

# Employees 25,000 # of Dependents 2.3# SSRx Members 57,500 % Rx Generic 80%% Rx Brand 20%Avg $ Generic $20Avg $ Brand $205Avg $ Rx $57Avg # Rx/mo/m 1Avg Rx Spend/Mo 3,277,500$ Avg Rx Spend/Yr 39,330,000$ Conservative Savings Est. 35.0%$ Savings w SSRx 13,765,500$

Page 7: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

INFORMATION FOR BETTER OUTCOMESSSRx Connects to Employees Giving them Control of Their Outcomes

7SimpleSaveRx All Rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

Pharmacy Finder SSRx app helps you find the nearest pharmacy and available services using Google Maps

One-Click TransferUsing the SSRx App, simply click on the pharmacy where you want to transfer your Rx to and we will handle the rest

Pharmacy-to-You PricingTrue Transparent Pricing from our partners to our members. No spreads, no hidden costs. Employees shop around for the best price and services using our app

Click-2-SaveMembers receive notifications when lower price options exist for their active Rx

Page 8: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

8SimpleSaveRx All Rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

TRUE BUSINESS INTELLIGENCEReal-Time Reports Give Employers Visibility to $ Spend & Benefits

SimpleSaveRx has a robust reporting system and back-end that can process billions of transactions daily.

Choose from a library of 300+ reports and views to get full visibility and transparency into your spend and benefits programs

Page 9: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

SSRx BENEFITS & REWARDSThe First Flat Fee-Based, Fully Transparent PCM

PBMs

Rx Prices

Model Per Prescription Flat Monthly Fee

Transparent PricingNot Disclosed, Hidden Fees

Discounts & Rebates Pass-ThruRetained or Negotiated

Consulting Fees Included in Offering$10 - $125 / member / contract

Pharmacy Promos IncludedNot Included

Transparency SSRx ApplicationNot Disclosed

Rx Spend Managed ContributionUnpredictable

9

Control Your Rx Budget

Information = Better Patient Outcomes

Pass-Thru Pricing

SimpleSaveRx All rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

Page 10: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

David Kwasny, CEO• Former CEO/president of Restat, one of top 15 PBMs in U.S. with over 10MM lives served. 12 years at Restat

in Sales and Business Development• CEO of U.S. HealthCenter, a start-up business in predictive modeling• Registered pharmacist (R.Ph.) With active license, worked at K-Mart Corp.

George Herman, CTO• President/owner, Distributed Systems Solutions Inc., leading edge consultancy for IT innovation• 20 years of technology development experience for clients including American Express, AT&T, Motorola,

McKesson, Gannet, and Albertsons• Expert in healthcare data, pharmacy claims, web/eCommerce, big data

Nick Soldo, COO• COO DSSI drove company to 18 years profitability from onset and instilled operational excellence• 30+ years as an operational and finance manager• Licensed as a CPA in Arizona; Masters from ASU

Matt Winberry, VP of Sales & Marketing• Co-founder and Partner GameSpy Industries, an on-line video game community portal with a multitude of web

properties which was sold to Fox Interactive & IGN networks• Services Director Cisco. IT industry expert with innovation incubation & dotcom startup experience• Experienced in IP licensing, community web presence development, B2B development

Melanie Cantua, VP of Service & Delivery• Mobility industry expert with experience transforming Fortune-500 operations for maximized savings• Director, Motorola Solutions driving mobility solutions to healthcare, government, and retailers globally• 20 years of experience in service development and delivery at Ernst & Young, Avaya and Motorola

Dr. Adam Fein President, Pembroke Consulting, and leading expert in Pharmaceutical supply chainBrooks Pettus President, QualVU, leading online web B2B market researchStephen Buck Founded RxDividends, a B2B pharmacy sold to GoodRx, Vice-President, McKesson

OUR EXECUTIVE TEAMDeep Expertise to Win with SimpleSaveRx

10SimpleSaveRx All rights Reserved. Confidential Restricted – Use Pursuant to Company Policy.

Advi

sors

Page 11: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

Doug Hall, Senior Network Solution Architect•20+ years experience in large scale system and network architecture. Lead Agile multi-platform architect and developer for Java, C++, HTML•Director of Operations at Motorola Inc. for Info. Enterprises•CTO for Sandbox Entertainment and founder of Unicon eLearning

Daniel Horn, Senior Solution Architect •20 years experience in systems development and integration for high volume transaction processing systems. Agile development with Java, C++, HTLM, CSS, and more •Specializing in customer service centric solutions for retailer, Call Center, coupon and loyalty marketing

Ron Watkins, Senior Solution Architect•17 years experience in large scale system integration and infrastructure. Storage area networking and infrastructure management leader in healthcare, pharmaceuticals, financial services, and aerospace industries •NASA flight controller responsible for flight operations, communications, telemetry and processing

John Gilmer, Senior Solution Architect •20+ years experience in large scale data base and system architecture. Agile application development for healthcare, pharmaceuticals, banking, and retail•Systems Engineering lead at Motorola new enterprises and STI satellite communications

Tyler Herman – Systems Engineer & Analysis Leader•Lead Systems Engineer & Analysis for Distributed Systems Solutions Inc., leading edge IT consultancy utilizing Agile/Rational Unified Process design methods •Sales and Marketing for large group ticket sales and half-time sponsorship for Globe Trotters

OUR TECHNICAL LEADERSHIPDeep Expertise to Win with SimpleSaveRx

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Page 12: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

RAPID APPLICATION DEVELOPMENT FOR BIG DATA SYSTEMS

MISSION-CRITICAL PROCESSING SYSTEMS HANDLING BILLIONS OF TRANSACTIONS DAILY

FULLY HIPAA-COMPLIANT AND ISO 9000-CERTIFIED

50+ CUSTOMER SUCCESS STORIES& A PRESTIGIOUS PROJECT RECOGNIZED BY SMITHSONIAN

OUR COMMITMENT TO EXCELLENCELeveraging our DSSI Heritage of 18 Years of Quality Services

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I also want to thank our partners at DSSI…They inspired us to think beyond what we knew and

helped guide us each step of the way –Peggy Yelinek, Vice President, McKesson

Page 13: PHARMACY BENEFITS the Right Way Pure Pass- Thru Pricing ...blog.riskmanagers.us/wp-content/...Benefit-Overview-Condensed-201… · Services Overview. Purchase Rx’s at the Pharmacy

THANK YOU!

For More Information, Contact:

Bud Brooks

Brooks Healthcare Solutions

w. 972-239-6992

c. 214-649-4378

[email protected]

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