Public Sector Market Drivers

Public sector organizations that provide prescription drug benefits are faced with the daunting challenge of managing rising drug costs with diminished budgetary resources.

At the federal level, Medicare Part D has introduced prescription drug benefits to the Medicare program, which has sent program costs soaring; up by 18.7% in 2006 alone, more than double the increase in 2005*. Meanwhile, State Medicaid programs are looking to organizations to provide innovative strategic initiatives designed to manage escalating costs without diminishing the level of services offered.

Public sector organizations are searching for solutions that deliver both cost-containment initiatives while enhancing patient care. Medicaid and other government programs are looking for PBMs and PBM technology companies that understand the unique public sector environment and have the flexible platform required to accommodate their special needs. These organizations need a competitive fee-for-service model with a robust claims processing engine supported by strong clinical and benefit design support, consultation and knowledgeable staff.

* House Oversight and Government Reform Committee

We deliver transparency, flexibility and choice

SXC’s applications and services enable customers to: apply their benefit design to their own unique standards with greater automation and flexibility; decrease administrative costs without compromising service quality; and enhance understanding of public entities’ needs for pharmacy spend management, requirements, and regulations.

SXC’s products and services for the public sector include:

SXC provides solutions to groups in the public sector in both the U.S. and Canada that include: State Medicaid, Provincial Drug Programs, Federal Programs, Department of Defense, Veteran’s Administration, State Employees, and Medicare Part D. SXC’s fee-for-service model delivers the flexibility and transparency of operations that is required by public sector organizations, and helps them to control their drug program costs. Our ability to combine our tools, technology and expertise into a custom package suits the public sector model where each public sector client operates unique programs and requires a partner that can interface with other vendors, and seamlessly support new requirements as needed.