Insurer’s pharmacy deal on high-cost prescriptions goes ahead
An exclusive deal between the health insurer Allshores Ltd and Phoenix Pharmacies, postponed for 60 days in March after the insurer held discussions with the Bermuda Health Council and the Government, has come into effect today.
Allshores said the partnership, which restricts where clients can purchase certain high-cost pharmaceuticals, including weight-loss drugs, lowers costs on “a small list of very expensive drugs” representing 3 per cent of prescriptions but a third of prescription costs.
A spokeswoman said: “The remaining 97 per cent of prescriptions can be sourced with the usual coverage at a member’s pharmacy of choice.”
She added: “We are not the only insurer who has a network pharmacy, which can offer lower costs to its members.
“The difference with Allshores is that we are setting up our network through a partnership with a Bermudian company, rather than through ownership.
“At the heart of this initiative is a commitment to ensure members receive the care they need without financial hardship.
“By reducing the acquisition cost of these specialist medications, we have been able to expand coverage to 100 per cent for most eligible members — removing significant out-of-pocket costs that many patients previously faced.
“This approach allows us to improve access to life-changing treatments while helping maintain affordable and sustainable health plans for employers and members alike.”
She added: “We have good news for members living with diabetes who use GLP-1 medications. Based on several years of clinical experience and feedback from our physician community, pre-certification is no longer required for members diagnosed with diabetes.
“We remain committed to making access to care as simple and effective as possible and will continue working with our physician partners to modernise the authorisation process for obesity and weight management treatments. We encourage members to work closely with their doctors to determine the most appropriate treatment plan for their individual health needs.”
Details on the pharmacy arrangement, with a list of medications covered, can be found at allshores.com/pharmacy. Members can also review their schedule of benefits and e-mail queries to pharmacy@allshores.com.
