San Antonio Company Saves Self-Funded Employers Big Bucks

 To fight high drug prices, Utah will pay for public employees to go fill prescriptions in Mexico……………..

SOURCE: Low Cost Prescriptions and Healthcare | Apollo Vanguard

Apollo Vanguard understands the health insurance industry with it’s complexities and utilization of the services from physicians, hospitals, pharmaceuticals and other related expenses. We have made it our mission to diligently search for best quality of health practices with low but reasonable cost.

A number of industry publications agree that prescriptions and hospital charges are the two highest cost drivers for any health plan …Specialty Prescriptions being the highest cost. While almost every US health and insurance professional focuses on what they can do to market their focused area we at Apollo Vanguard provide a global reach with over 12 years of experience. While we offer multiple services the three areas of greatest impact are Pharmaco TravelPharmacogenomics and Medical Travel.

Pharmaco Travel offers the lowest cost Brand Name Specialty Prescriptions with access to the same manufacturers / wholesalers in Mexico. These prescriptions are priced to the global market unlike the US market with multiple layers of resellers. Patients receive their medication often 3 to 7 times higher in the US because of this convoluted system. The savings through ApolloVanguard are 35% to 75% lower through this global market.

Pharmacogenomics is testing individuals for a geno-type that determines how genes react to certain prescriptions. The aim is to identify what medications work best and at what dosage. It also prevents adverse reactions or even death because of certain genes and how they interact with other prescriptions. Specialty prescriptions are costly so it makes sense to personalize the right medication at the right dose at the right time.

Medical Travel allows a patient to seek treatment in other parts of the country or internationally for reasons such as higher quality, lower cost, shorter waiting period or specific treatments not available. ApolloVanguard can assist in identifying these facilities and doctors. With 23 countries and countless of credentialed facilities reviewed, a patient can feel comfortable knowing safety and successful outcomes are at the forefront.

News | Apollo Vanguard

To fight high drug prices, Utah will pay for public employees to go fill prescriptions in Mexico

By Erin Alberty

Amid a flurry of national proposals to bring exorbitant U.S. drug prices in line with other countries’ charges, one Utah insurer has a different option for patients:

Pay them to go to Mexico.

PEHP, which covers 160,000 public employees and family members, is offering plane tickets to San Diego, transportation to Tijuana, and a $500 cash payout to patients who need certain expensive drugs for multiple sclerosis, cancer and autoimmune disorders.

“That money is pretty small in comparison to the difference between U.S. prices and Mexico prices,” said Travis Tolley, clinical operations director for PEHP.

The insurer rolled out its “pharmacy tourism” option this fall in response to state legislation requiring state employees’ insurance plans to offer “savings rewards,” or cash incentives, to patients who choose cheaper providers.

PEHP is offering pharmacy tourism benefits for about a dozen drugs for which the price disparity between countries is vast. For example, Avonex, which treats MS, costs about $6,700 for a 28-day supply in the U.S., but about $2,200 through PEHP’s contracted clinic in Tijuana.

For three months’ supply — the maximum allowed under the program — the savings of $13,500 more than covers the $500 reward and transportation, typically less than $300 per person.

“Why wouldn’t we pay $300 to go to San Diego, drive across to Mexico and save the system tens of thousands of dollars?” asked state Rep. Norman Thurston, R-Provo, who sponsored the legislation calling for incentives. “If it can be done safely, we should be all over that.”

Patients who participate will fly to San Diego, be driven through a priority lane at the border crossing and arrive at a clinic, which PEHP director Chet Loftis described as “top-notch,” comparable to a Mayo or Cleveland clinic in the United States.

Medical tourism is not new; PEHP itself has previously offered coverage for out-of-country medical procedures. But without the cash incentives, patients haven’t used that option, Loftis said. Now that clients are eligible for up to $3,900 a year in reward payments for trips to Tijuana for procedures and drugs, Loftis said he hopes more will participate.

“It makes sense to not only pay for the cost,” he said, “but also to provide an incentive.”

The pharmacy tourism incentive is launching as Trump administration officials are focusing on the disparity between drug prices in the United States and in other countries. On Thursday, President Donald Trump announced a proposal focusing on the price of drugs under Medicare Part B, which covers cancer drugs and other drugs given to patients in hospitals. Federal law at present forbids Medicare from negotiating lower drug prices — a rule that Congress has resisted changing — but Trump proposed a trial that would limit Medicare payments for certain Part B drugs to prices closer to what other countries negotiate.

The experiment would apply only to half of Medicare recipients, in select areas of the country, and to some doctor-administered drugs.

For other insurers, like PEHP, the border may remain the closest shot at savings.

“When you start looking at the list at these higher-priced drugs people are taking, you think, ‘How in the world can there be such a big price differential between the U.S. and other countries? What’s going on?’” Thurston said. “Why wouldn’t we fly our employee to Mexico?”


Here are the drugs that qualify for Utah’s pharmacy tourism benefit, and the illnesses they are generally used to treat.

Ampyra, multiple sclerosis

Aubagio, multiple sclerosis

Avonex, multiple sclerosis

Copaxone, multiple sclerosis

Enbrel, autoimmune disorders, such as psoriatic and rheumatoid arthritis

Forteo, osteoperosis

Gilenya, multiple sclerosis

Humira, arthritis, plaque psoriasis, ankylosing spondylitis, Crohn’s disease and ulcerative colitis

Orencia, rheumatoid arthritis

Otezla, psoriasis

Stelara, plaque psoriasis and psoriatic arthritis

Tecfidera, psoriasis

Zytiga, prostate cancer


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