OUR VOICES MATTER

Meet David, the Health Benefits Consultant

You shouldn’t have to skip vacations to pay for medications

As a 20-year veteran of the health insurance/health benefits industry, David Contorno knows that reducing the cost of medications are the number 1 way to help his employer clients and their employees pay less out-of-pocket. David has helped hard-working folks like ‘Maria’ at a Wisconsin-based manufacturer save thousands of dollars annually. One day, Maria knocked on the door of her Chief Financial Officer, Mark, with a surprised look on her face, “Mark, I just wanted you to know that our insurance company made an error on my medical bill; I just refilled my medication and they say my balance is $0. I’ve been getting this prescription for 8.5 years and it usually costs about $700 a month!” Maria said.

“Oh, excellent,” Mark replied, “We just changed our health plan last month to avoid the extra fees and out-of-pocket costs from a Pharmacy Benefit Manager – and now that you are able to purchase your medication from a lower cost distributor, we cover the rest of the cost of the medication.  It’s our way of saying ‘thanks’ for being a good shopper.”  Only tears and a long hug followed from Maria. “You just saved my family $8000 dollars a year!? If this is real, then I finally get to take my family on a vacation and treat my husband to a birthday dinner!”

Carve it out to keep it affordable

Veterans like David are taking on corporate PBMs that design prescription health plans to exclude most specialty medications like Maria’s on their ‘covered list’. Without David’s help, Maria wouldn’t have access to that medication through the health insurance her employer provides.  By working directly with the manufacturers, David is able to cut out profit seeking middlemen, and help low- and middle-income employees like Maria acquire specialty medications at no cost.

A little help from his friends

Pharmaceutical manufacturers offer financial assistance to people who cannot afford their medications because of income or if that medication isn’t covered under their health insurance plan. Systematizing programs that help identify and leverage patient financial assistance programs is paramount to ensuring success stories like Maria’s. David is simply working to ensure that his clients are paying exactly what they should for their medications… or a little less. For the Wisconsin-based manufacturer Maria works for, David helped save about $400,000 annually on the cost of healthcare coverage for their employees. Unfortunately, this story isn’t uncommon – most of the employers David works with are overpaying for healthcare coverage by at least 25%.

David works directly with international sourcing companies, pharmacy medical plan partners, and other honest brokers in the system to minimize cost liability to his clients. 

Most Americans overpay exorbitant amounts of money for their prescription drugs, but it doesn’t have to be this way—David’s business is built around a model that puts employers and patients first—to ensure they are sharing the savings available to them in the drug supply chain.