Independent methodology review affirms Abarca’s net cost pricing solution—Assura—is transparent & predictable

Apr 20, 2022

AVENTURA, FL — Abarca, a pharmacy benefit manager (PBM) that is disrupting the industry with a new approach to technology and business practices, has released the findings of an independent report about their drug cost guarantee solution, Assura. The review, conducted by the respected global healthcare consulting firm Milliman, found Abarca’s approach to be actuarially appropriate.

“This is the first solution of its kind – PBMs typically don’t take on the financial risk of higher drug costs,” said Jason Borschow, Abarca’s President & CEO. “We created Assura because we are fully committed to the success of our clients, and we’re ready to put our money where our mouth is.”

Assura guarantees the net cost of drugs, including specialty medications, by offering an annual fixed per script cost for a health plan’s entire population. The guarantee is adjusted each year based on drug benefit coverage changes. This helps protect payers from the risks of high-cost medications and drug mix changes, and brings much-needed predictability to drug spend.

To evaluate this approach, Milliman conducted a thorough independent methodology review of Abarca’s reconciliation process to ensure that all calculations and methodologies used to deliver the net-cost guarantee were appropriate. As a result, the study affirmed that Abarca’s methodology and calculations are actuarially appropriate.

“We agree that it is an appropriate methodology and that the calculations we reviewed from Abarca follow the prescribed methodology and are actuarially appropriate,” the report stated. “We believe the arrangement provides transparency and predictability while including a straightforward methodology for reconciliation.”

A copy of Milliman’s report can be found here.

“Assura reflects two principles that are fundamental to our company,” continued Borschow. “We do what we say, and we are ready to discard the traditional PBM playbook in order to deliver greater value and find a better way in healthcare.”

To learn more about Assura, click here.


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