Abarca’s financial model Assura receives PBMI Excellence Award for Cost Containment Strategies

Sep 15, 2022

Aventura, FLAbarca, a pharmacy benefit manager (PBM) that is transforming the industry with a new approach to drug trend management and business practices, has been awarded the 2022 PBMI Excellence Award for Assura, the company’s innovative financial solution, from the Pharmacy Benefit Management Institute.

“Assura gives health plans the ability to manage and predict drug spend in an increasingly volatile market,” said Jason Borschow, president and CEO of Abarca. “It’s time PBMs act like true partners and help protect clients from runaway costs.”

Through Assura, Abarca guarantees the net cost of drugs, including specialty medications, by offering a fixed, per-script cost for a plan’s entire population. The guarantee is adjusted annually based on drug benefit coverage changes. Assura is designed to protect plans from the most common sources of cost increases, including drug mix and inflation, but it goes a step further by:

  • Promoting biosimilars through formulary management
  • Deploying targeted step therapies to drive utilization of low-cost generics first for both traditional categories as well as categories that are not typically managed in this way
  • Optimizing coverage “pathways” for autoimmune drugs
  • Deploying limited and preferred pharmacy networks

By implementing Assura, a commercial health plan serving more than 250,000 lives was able to make its drug spend more predictable and manageable in under one year. Previously, the plan was experiencing volatility in its overall drug spend, driven by unexpected specialty drug utilization. With Assura, the plan saw improved trend, greater predictability, and decreased administrative burden.

“We applaud Abarca’s innovation in cost containment and the introduction of Assura,” said Brian Haug, executive director of the Pharmacy Benefit Management Institute. “Cost management is one of the most critical services offered by PBMs, and this forward-thinking model is a perfect example of the type of solutions the industry should be delivering.”

A recent third-party evaluation, conducted by an independent healthcare consulting firm, concluded that Assura’s methodology was appropriate and worked as promised—affirming that it offers predictability and a straightforward reconciliation process.

Since 2016, the PBMI Excellence Awards have recognized organizations for groundbreaking strategies addressing several challenges within the healthcare industry. The winning organizations are being recognized for developing best-in-class strategies to address the challenges of drug cost management, quality improvement, and care management strategies. All submissions were reviewed and scored by an evaluation panel, then further ranked based on their contribution to improving outcomes and processes.

Learn more about Abarca’s innovative new financial solution, Assura.

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