New Benchmarking Lessons Learned

Vital Incite has recently expanded its benchmarking in several key reports.  

• PBM comparison to NADAC- The Vital Incite benchmark has been edited to remove groups that adjudicate estimated rebates at time of sale. That has shifted the benchmark to 111% of NADAC, with rebates benchmarking at 30%.

• Pharmacy Trends now include benchmarking by plan paid by diagnostic category. This will allow advisors and employers to further understand the outliers in their plan to determine if increased spend is driven by either cost or utilization.

• MSK considerations: Benchmarking has allowed a group to more quickly identify if the MSK spend is due to incidence rate or cost of care. This will more quickly identify next step strategies.

• Cancer benchmarking now shows members per 1,000 by cancer type, allowing us to more quickly identify groups with higher incidence of cancers, and by cancer type.

• Mental Health benchmarking includes benchmarks for incidence rates by diagnostic categories and then by diagnostic categories and dependent status. This has already proven to help, more effectively, identify where opportunities exist, and where resources are beneficial.