Welcome to IBA

Controlling Unnecessary Pharmacy Spending

Maintenance Cost

By increasing the use of 90-day mail pricing, clients can save an average of 4% of their total pharmacy spending. Maintenance Choice leverages the cost savings and convenience of mail and the option of using CVS/pharmacy for a 90-day supply of maintenance medications, giving members more choices and accessibility to medication.

Generic Step Therapy Design

On average, plan sponsors subsidize 80% of the cost of brand medications, but only 70% of generics. This program helps shift these percentages to more cost-effective generics, which save our clients money, while still providing top-quality care for our members. The program is designed to help promote and encourage evidence-based utilization of generics and low cost brands.

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Utilization Management Program

  • Retrospective “safety net” reviews all claims for serious drug-drug interactions, within 72 hours.
  • Ongoing Fraud and Misuse monitoring that sends actionable, member-specific drug profiles to physicians.
  • Targeted, ongoing evaluation of client-specific utilization management edits for cost-effectiveness and impact on member satisfaction.
  • Online Prior Authorization for quicker turnarounds and better access to information.
  • Enhanced solutions, which include more in-depth claim reviews by pharmacists and guaranteed ROIs.

Specialty Guideline Management

Specialty Guideline Management (SGM) focuses on utilization for specialty medications. SGM goes beyond traditional prior authorization by including reviews for medication appropriateness and continual follow-up with the patient. SGM can save our clients up to 5% on specialty pharmacy costs, which overall, can provide substantial savings. Overall, the goal of SGM is to ensure that the patient gets the right medication, at the right time, for the right duration.