Vendor says RxCompass program could net St. Martin Parish Schools roughly $450,000; weight‑loss drug program would be voluntary with clinical screening

Marcy Maloney, an account executive at Lavinity, opened the board presentation by identifying her firm’s role working with St. Martin Parish Schools and introducing Tom Lane, Lavinity’s senior executive, to review proposed pharmacy and wellness programs. "I'm the account executive here at Lavinity for St. Martin Parish Schools," Maloney said at the start of the presentation.

Lane framed two primary savings pathways the vendor proposed for the district’s benefits plan: a patient‑assistance route that helps members apply for manufacturer programs that can provide medicines at no cost and an international mail option that sources drugs from lower‑cost Canadian pharmacies. "That represents about $450,000 in savings," Lane said when summarizing the program math, adding that the vendor identified 27 unique members and 106 prescriptions tied to the most expensive drugs on the plan.

According to Lane’s presentation, the 106 prescriptions could produce about $585,000 in gross savings; Lavinity’s administration fees for the proposed program were listed in the deck as $135,000, producing a net savings figure of about $450,000 and a vendor‑stated fee‑to‑savings ROI of roughly 4.31. The vendor characterized the patient‑assistance route as income‑based (examples given in the presentation were families of four at about $140,000 or individuals around $60,000) and said prior authorization and clinical review would be required before enrollment.

Lavinity also detailed a buy‑program combining a GLP‑1 companion (weight‑loss) product with diabetes‑prevention services and behavioral‑health supports. The vendor said the marketplace includes drugs called in the transcript Wegovy, Saxenda and Zepbound and described these therapies as significant cost drivers for pharmacy spend. Lane told the board that if the district elected coverage for GLP‑1 drugs through Lavinity’s international mail option, the vendor estimated an average cost of about $750 per month per member — roughly $4,500 for a six‑month course — and said clinical authorization plus active participation in behavioral‑health services would be required to obtain and continue coverage.

Maloney also recommended covering pharmacy‑administered vaccines; she said the presentation’s scenarios show an estimated plan‑cost increase of a few thousand dollars depending on plan design and whether vaccines were moved to a $0 copay for members. "Most of these vaccines that you'll see on the screen are brands preferred," Maloney said. The vendor’s rough calculations presented a range of plan‑cost impacts; board members asked staff to return with precise numbers.

Board members questioned whether any parts of the vendor proposal would be mandatory. Lavinity representatives said the RxCompass routing for the identified high‑cost prescriptions would be mandatory for the specific group of members and prescriptions the vendor had identified, and that those members would have $0 out‑of‑pocket costs when those fills were routed through the program. By contrast, the GLP‑1 weight‑loss program would be voluntary and limited to clinically appropriate members after prior authorization and engagement in the behavioral supports the vendor described. The vendor also stated it had verified the identified members were not currently filling those prescriptions at local community pharmacies and therefore did not expect local pharmacy business to be displaced.

The board did not take an immediate vote on enrollment or coverage; Lavinity representatives said they would return with a fuller cost breakdown and implementation details at the next meeting.

What’s next: Lavinity will provide detailed cost calculations and an implementation plan at the board’s next meeting so the board can consider whether to adopt the RxCompass program, add vaccine coverage options or add coverage for GLP‑1 drugs subject to clinical screening and behavioral‑health participation.