Providing Access to Uncovered Specialty Medications with Paul Pruitt SHARx

Paul Pruitt, Chief Growth Officer at SHARx, which is a company that partners with employers to provide access to drugs not covered by insurance, such as specialty medications. The SHARx model acts as a complementary service to existing Pharmacy Benefit Managers and allows employers to opt out of covering the most expensive drugs. Paul's personal experience managing his sons' rare condition and navigating the administrative burden and frustration of the insurance system gives him deep insights into the factors driving up the cost of medications.

Paul explains, "When we started SHARx eight years ago, the really highest cost biologics and what we call specialty medications were about 35% of the dollars that were being spent within a pharmacy program. And this year, we rarely see it under 50%. So it's really become a huge issue that we're noticing and realizing why many employers have to make the jump to do something different."  

"The highest cost medications are 1% to 5% of how a plan is used on the pharmacy side, but it's 90% of the dollars. So we've seen a lot of employers say, "Hey, we really care about our employees. We want to offer great benefits, but if we can't stay in business or offer a plan at all, then what good is that?" So what changes can we make? And that's where they come to us and say, "Hey, we can't participate. We may not be able to cover these medications this way going forward, but because we care about our folks, we want them to have access more affordably." That's why they partner with SHARx so that we can deliver that type of service to their people after they've made that determination of what they can and cannot cover any longer."  

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SHARxplan.com

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