JACKSONVILLE, Fla. — The Duval DOGE Committee was told the city could be saving millions on its health plan by switching pharmacy benefit managers, and the committee chair is calling on the mayor to make the swap.
The city could save more than $4 million a year simply by switching its pharmacy benefits manager.
That’s the conclusion reached by the Bailey Group, the consulting firm hired by city council to take a deep dive into the city’s health plan.
Presenting before the Duval DOGE committee, the firm explained the savings would come through higher rebates and additional savings programs offered by ExpressScripts.
“I’d like to hear from people who are involved in this process. Why did we leave that much in these rebates on the table every year?” Councilmember Chris Miller (R-Group 5 At-Large) said.
While the purported cost savings wouldn’t offset the full $23 million deficit the city’s health plan is currently running, it would take a chunk out of it.
But changing the city’s pharmacy benefits manager is not within the control of the council.
Instead, the change would have to be implemented by the mayor’s office.
Duval DOGE Chair Ron Salem (R-Group 2 At-Large) argued given the potential savings and the minimal impact on the 6,000 city employees and their family members who utilize the city plan, the mayor’s office should seriously consider the switch.
“It’s not complicated at all. I mean, when police and fire pulled out of the city plan, they switched pretty quickly to ExpressScripts and have seen the savings. So, this is not pie in the sky stuff,” Salem said.
The Mayor’s Office sent a statement suggesting the Bailey Group’s analysis didn’t factor in cost savings already implemented by the administration.
“While we will always welcome input, the administration has a world-class consultant that has explored and implemented solutions which have already delivered more than $12 million in savings,” a spokesperson for the mayor’s office said. ”We’re concerned that the analysis isn’t a true apples-to-apples comparison of the plans and could negatively impact the quality of care that employees currently receive.”
The Bailey Group estimated 237 policyholders may have to change medications under its proposal, but Salem argued there are ways to alleviate the pain.
“Other people can help them identify other drugs in a particular class. I’m a pharmacist, as you know. This is not unusual and it can generally be worked out very easily,” Salem said.
The report also found two GLP-1 medications topped the list in terms of costs to the city, accounting for a combined $3.2 million annually.
Those medications can be used for weight loss or diabetes.
While the city’s health plan doesn’t cover the medications for weight loss use only, Salem argued there could be a need for further scrutiny to ensure the nearly 500 policyholders receiving the meds aren’t abusing the system.
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