Inflammatory
Stelara 90MG
#1
Current Spend
$220.53K
Plan Savings
$108.84K
Member Savings
$12.01K
Highest single savings opportunity — eight scripts, six-figure plan impact.
RxProtect identifies the small percentage of prescriptions driving the majority of pharmacy spend and creates a targeted strategy to reduce cost while improving medication access for members.
Only 8.1% of prescriptions were reviewed. Yet those prescriptions account for 73.7% of total pharmacy spend.
That concentration creates a modeled savings opportunity of $2,326,586 while simultaneously reducing member out-of-pocket costs by $487,704.
This is why RxProtect focuses on a small number of high-cost medications instead of disrupting the entire pharmacy benefit.
The analysis identified a concentrated group of high-cost medications responsible for a disproportionate share of pharmacy spending.
Rather than redesigning the pharmacy benefit for every employee, RxProtect focuses only on the medications creating the greatest financial impact.
The result is a highly targeted strategy that lowers cost, improves medication access, and reduces member financial burden.
Highest single savings opportunity — eight scripts, six-figure plan impact.
Concentrated specialty utilization with meaningful member out-of-pocket relief.
Predictable refills, clean handoff with minimal member friction.
Strong dual impact: plan savings and largest member-paid reduction in the top five.
Targeted oncology therapy — small cohort, outsized financial leverage.
Moderate utilization, high savings yield per script.
| Medication | Scripts | Plan Cost | Plan Savings ↓ | Member Savings | Savings % | Disease State |
|---|---|---|---|---|---|---|
| Stelara 90MG | 8 | $220,533 | $108,836 | $12,008 | 49.4% | Inflammatory |
| Skyrizi Pen 150MG | 8 | $158,390 | $66,244 | $20,365 | 41.8% | Inflammatory |
| Enbrel SureClick 50MG | 15 | $104,420 | $55,949 | $13,808 | 53.6% | Inflammatory |
| Tremfya One-Press 100MG | 10 | $124,111 | $51,699 | $20,542 | 41.7% | Inflammatory |
| Ibrance 75MG | 8 | $125,237 | $48,533 | $4,500 | 38.8% | Oncology |
| Taltz 80MG | 18 | $116,046 | $44,702 | $14,204 | 38.5% | Inflammatory |
| Kisqali 200MG | 7 | $120,710 | $44,185 | $11,024 | 36.6% | Oncology |
| Alecensa 150MG | 10 | $194,055 | $40,197 | $0 | 20.7% | Oncology |
The opportunity extends beyond plan savings. Every dollar removed from member out-of-pocket burden improves affordability, medication access, and the overall benefits experience.
Removing medication cost barriers improves adherence — and creates better health outcomes.
RxProtect does not create the opportunity. RxProtect reveals it.
The next step is validating the assumptions, confirming target medications, and launching a member-first savings strategy.