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Driving optimal health outcomes and client satisfaction through innovative health plan solutions

October 13, 2020

Medavie Blue Cross is pleased to unveil its new, flexible drug management solution, Rxperience - Powered by Medavie Blue Cross Drug Solutions. As the drug landscape continues to evolve, the pharmacy benefit manager and insurer is committed to ensuring drug plans are cost-effective for its clients, while supporting positive health outcomes for its members.

“Our commitment as a health solutions partner is to improve the wellbeing of Canadians,” says Shane Reid, Director, Drug, Product and Provider Management, Medavie Blue Cross. “We leverage our in-house expertise and capabilities to assess, negotiate and recommend to our clients the best approaches to maximizing the outcomes of their drug spend, while ensuring plan members get access to the most appropriate therapy for their condition.”

Beginning with increased standardized core benefits, Rxperience offers broader drug coverage, open access to traditional drug benefits and specialty drug management, all with less administration and more cost-savings. The overall plan strategy was designed to give clients an opportunity to take control of their health benefit challenges. Additionally, to create easy-to-understand plans that meet the specific needs of both their employees and their business through additional benefit modules, enhanced coverage and plan management features. This flexibility allows for more tailored client-focused health solutions and is adaptive to new or existing plans.

Plan Elements

Rxperience Standard Features

  • Open benefit for all eligible non-specialty drugs
  • Expert management of high cost specialty drugs, guided by expertise from Medication Advisory Panel
  • Key Plan Management Features that focus on member care and cost management tools that seamlessly integrate with any additional automated features to help control unnecessary plan spend:
    • Prior Authorization for high cost specialty drugs
    • Mandatory Generic Substitution for multi-source brand drugs
    • Opioid Management Strategy for responsible drug utilization

Add-on Automated Plan Management Features

  • Tiered coinsurance - Rx Choices®
  • Automated Step Therapy
  • Maximum Allowable Cost *In Quebec, only applicable for gastrointestinal medications
  • Pharmacy Partners-Preferred Network *Not available in Quebec
  • Usual and Customary (U&C) Pricing *Available in Quebec only

PLUS the flexibility to enhance coverage with additional benefit modules!

According to Reid, “With Rxperience, our focus is offering a plan that allows for increased access to medications and variety, providing our plan sponsors with sustainable, flexible options, and most importantly, reducing administrative barriers to health care. We want to ensure that every dollar spent gives members the care and support they need, and an ability to make informed health care decisions about their medications.”

Medavie Blue Cross’ position as a pharmacy benefit manager and an insurer has allowed the company to develop a set of unique in-house capabilities that are key to fueling Rxperience and include:

  1. Clinical and Therapeutic Expertise that informs the ability to make the right drug decisions,
  2. Technology Platforms that offer a seamless member experience,
  3. Health and Disability expertise that allows the creation of synchronized benefit offerings for holistic member care,
  4. Strategic Partnership Networks, including relationships with pharmacies, manufacturers and suppliers that drive quality and increase overall access, and
  5. Analytics and Insights that provide access to data-driven trends and plan innovation.

By bringing all of these capabilities together in one plan, Medavie Blue Cross Drug Solutions has created an innovative health plan solution that helps drive optimal health outcomes and client satisfaction while delivering a new standard in flexible drug plan management -- Rxperience.

About Medavie Blue Cross

Medavie Blue Cross is a premier all-in-one carrier that provides health, dental, travel, life and disability benefits, and administers various federal and provincial government-sponsored health programs. Together with Medavie Health Services, we are part of Medavie, a health solutions partner committed to improving the wellbeing of Canadians.

We are one of Canada’s Most Admired Corporate Cultures and recognized as an Imagine Canada Caring Company. As a not-for-profit organization, we are proud to commit an annual social dividend to the Medavie Health Foundation to support programs and initiatives aimed at addressing some of our country’s most pressing physical and mental health care challenges.

For more information, contact:

Jacqueline Zonneville
Manager, Corporate Communications
W: 416-626-4955 | M: 416-571-6129
[email protected]