How Will Bennabis Health Benefit Payors?

By reducing your cost of care

Medical marijuana is currently legal at the state level in 39 states, and reimbursement by workers’ compensation carriers is required in 6 states….and growing.

Despite evidence that medical marijuana is appropriate, effective and safe for millions of people, the burden of self-payment by patients presents financial obstacles that many households can’t absorb on their own.  Unlike the formulas created by health plans for reimbursement of tiered prescription medicines, patients pay for this medicine out of pocket, with costs ranging from $300-$600+ monthly.  

These costs are prohibitive by comparison to monthly co-pays for thousands of prescribed medications that often come with side effects, follow up testing requirements and dosing schedules that don’t work well with busy lives. 

Peer review and patient-reported evidence is growing in support of monitored medical marijuana use as an adjunct or replacement medicine to improve health. With the growth of medical cannabis in almost 80% of all states, you need Bennabis Health as your partner in traversing this new frontier.

Bennabis Health is the expert in understanding and working with all health plan structures:

Our executive leadership has more than 120 years combined health plan experience  (it is our core excellence)

Bennabis Health is the first healthcare company working with innovative payors

  • self-funded group health plans
  • TPAs
  • fully insured and self-insured workers’ compensation providers

Our health plan model is easily integrated into existing employee benefit plans   

Our relationship with the Cannabis Education & Research Institute (CERI), our science research partner, is a robust and rich professional resource for your health plan professionals

We manage the relationship between your members and our contracted network of dispensaries

Bennabis Health manages the transactions between the payor and the dispensary, simplifying the process for both by enabling the payor to pay Bennabis Health rather than the dispensary. This provides payors with a layer of protection from uncertain federal risk.

Conditions Benefitting from Medical Cannabis:

Overall, there are 50+ medical conditions for which medical marijuana can be prescribed (varying by state).  Medical marijuana is most often used to manage chronic pain from MS, ALS, cancer and more.  It is used for rheumatoid arthritis, HIV/AIDS, seizure disorders and neuropathic and spinal pain.  Patients with glaucoma, Crohn’s disease and endometriosis have successfully used medical marijuana.

 

A key problem preventing more widespread use of medical cannabis is the lack of acceptance by physicians and other prescribers. While some prescribers eschew its merits, citing lack of peer-reviewed studies and clinical trials, patients are talking with their “mouse” and going to prescribers and plans that will support them and their medicine choices.  Addressing the need for physicians to support patient choice, Harvard Medical School Internal medicine professor,  Dr. Peter Grinspoon, recently wrote, “I often hear complaints from other doctors that there isn’t adequate evidence to recommend medical marijuana, but there is even less scientific evidence for sticking our heads in the sand.” Learn More – Harvard Health Blog – Medical Marijuana

We at Bennabis Health completely agree with Dr. Grinspoon.

Cost Considerations  

More than 4 million people in the United States are currently absorbing this cost personally.   However, due to the cost of medical marijuana, there are millions more people for whom medical marijuana is appropriate who must remain on formulary drugs and tolerate potential safety and side effect issues.

Health plans work diligently to provide the best coverage at the lowest costs. Incentives for good health and wellness are now included as part of many plan benefits, and considering coverage for medical marijuana may be among new benefit considerations in the future. Patient use of marijuana as medicine to mitigate and control symptoms of chronic diseases such as multiple sclerosis, chronic back pain, PTSD and more, is well known. There are suggestions that marijuana can ease withdrawals from substance use disorder as well. With the convergence of additional data and meta-analysis from clinical groups, the question of covering medical marijuana as a covered benefit will increasingly be asked. To date, the cost-benefit information has been limited, but a recent report suggests that the costs of coverage may be affordable.

Case Study: A patient with Relapsing-Remitting Multiple Sclerosis 

MS is the 5th most expensive chronic disease, with estimated costs of $5.60 PMPM and lifetime costs of nearly $4 Million. From 2006-2016, the annual costs for MS rose from $18,660-$75,847. Source: BusinessInsider.com: A new study reveals how the price of treatments for a devastating disease quadrupled over the past decade The MS Society website lists 87 medications that may be used to treat MS symptoms.

Anne* is a 50 year old mother of 2 daughters who is covered under your health plan.  Anne was diagnosed with relapsing-remitting MS in 2013 when her children were just 8 and 19, a critical time for her young family. Anne’s neurologist prescribed Copaxone, a first line treatment for her diagnosis.  Anne was told she would require daily injections, frequent laboratory testing to monitor vital organs and close monitoring.  Because of her busy life and schedule, Anne chose to start with medical cannabis which has fewer side effects and monitoring requirements.  Anne  continues to successfully use medical marijuana today. Anne’s neurologist, who was originally against her decision, has since advised her that she made the right choice.

By choosing medical marijuana, Anne shouldered more than $90,000, or more than $11,000 per year in out of pocket costs, a prohibitive amount for most people. 

By choosing medical marijuana, Anne saved your health plan $681,000 in drug costs alone over 8 years. Medical monitoring and lab fees as well as treatment of side effects add to the overall costs of just this one medication.

*Anne is a real MS patient: information was provided by her and used with permission. Note: Any testimonials found on this website are based on the experiences of those providing the testimonial. You may have different results or experiences and should always discuss your options with your physician.  For a complete copy of the Bennabis Health Medical Disclaimer click here.

This case study is only one of thousands of examples where both the patient and your health plan derive significant benefits.  Your patient is able to select their medication of choice, and you save hundreds of thousands of dollars in claims. 

Considering that scientific evidence demonstrates that medical marijuana is beneficial for more than 50 chronic conditions, Bennabis Health is prepared to assist you in creating a new benefit for everyone’s benefit!

CHECK BACK FOR UPDATES ON OUR LAUNCH OF PRODUCT DISCOUNTS AND HEALTH PLAN BENEFITS LATER IN 2021