SELWAY CAPITAL ACQUISITION CORP. FILES (8-K) Disclosing Other Events, Financial Statements and Exhibits
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Item 8.01 Other Events.
OVERVIEW
Products and Services
4
· Fully-funded Programs: A fully-funded prescription benefit plan takes the risk of overpayment from the client and passes it to the PBM in exchange for a higher fixed monthly cost. InHCCA's case, the risk passed on to the PBM is in turn passed toHCCA's reinsurance partners, removing the risk of loss from any one client account.HCCA is able to arrive at a total fixed cost for the plan that incorporates all of the client's requirements, delivers substantial cost savings, guarantees a certain monthly rate per member for the client, and providesHCCA HCCA's client with a known fixed cost per member. · Self-Insured Programs: Larger organizations can take the risk of total drug spending varying, and traditionally provide the drug benefit to their employees on a self-insured basis. Under self-insurance,HCCA simply passes on the actual cost of drugs, and it generates revenue via administrative fees and rebates. · Rx Savings Solutions: These affordable plans marketed under the "Savings Solutions" brand feature generic only or generic and preferred brand drug formularies, allowingHCCA to provide lower cost alternatives. At this point, this program is most often employed by smaller businesses that want to provide prescription drug benefits to their employees but cannot afford a traditional fully-funded or self-funded plan. ·Mail-Order Pharmacy :HCCA offers mail order pharmacy services to its PBM members.HCCA's mail order pharmacy service gives members flexibility, privacy, and easy access to their maintenance medications while offering significant plan savings to the client because we are able to take advantage of lower purchase prices, allowingHCCA to pass along extra savings to its customers. Unlike other PBM providers who outsource their mail order pharmacy services,HCCA's in-house pharmacy team operates its own mail order pharmacy directly fromHCCA's headquarters inDenville, New Jersey .HCCA believes this allows it to provide a higher standard of service and to assert greater control over fulfilling claims for members, as well as lowering costs. The Industry
According to
· Aging population. According to the
expected to age rapidly through 2030, when 19.5% of the population will be over
the age of 65, compared to 12.0% in 2000. Older Americans require more
medications than their younger counterparts - often 20 to 40 prescriptions
annually, according to the
According to the
prescriptions purchased in the U.S. increased 39% from 1999 to 2009, while the
population only grew 9%. The increase in prescriptions due to an aging
population is expected to drive demand for senior-focused clinical programs and
benefit plans which will address the prescription drug needs of an aging
population. 5
· Rising drug prices. According to IMS, the U.S. pharmaceutical market is
expected to grow at a 3% to 6% annual compound rate. Retail prescription prices have increased on average 3.6% annually between 2000 and 2009, according to Kaiser, a rate which is higher than the average inflation rate during that same period of 2.5%.
· Health care reform. The health care reform law enacted in 2010 is estimated to
provide drug coverage for an estimated 30-35 million people in the form of expandedMedicaid coverage, and this increases the PBM market by an estimated 20%, or$87.5 billion . In addition, the law may push more employers towards lower-cost prescription drug providers, whichHCCA believes may create demand for transparent PBM products.
· Generic Pipeline. According to IMS, the generic share of the overall
prescription drug market has increased from 67% in 2007 to 80% in 2011. Also according to IMS, over the next five years,$64 billion in branded drugs will come off patent in the U.S., fueling growth in the availability of generic equivalents.HCCA believes that this presents an opportunity for client cost savings and margin expansion for us. Generic drugs provide both immediate cost savings to the client and higher percent margins forHCCA's business, despite the lower revenue. Competition
In addition, the recent merger activity between
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Competitive Strengths
· Benefit Management, Plan Design and Cost Control:
base cost of services rendered by the incumbent PBM. From that point,HCCA overlays its known costs with the data from the client in order to model program cost, always in consideration of restrictions or guidelines the potential client may have built into their Request for Proposal (RFP) for the contract, such as use of certain pharmacies, name-brand/generic mix, etc. Finally, based on the final calculus of these costs and savings,HCCA passes on a sizeable portion of the reduced cost to the customer, while retaining the remainder as profit. By eliminating spread pricing practices used by other market participants,HCCA is able to outbid the competition while at the same time delivering its clients confidence in the fairness of its pricing.
· Reinsurance:
guarantee savings and administer effective fixed cost plans. The reinsurance removes the risk of loss associated withHCCA's guaranteed cost and fully-funded plans by stopping loss if drug spend is higher thanHCCA projected.HCCA gives up some margin for this service, but eliminates the risk of loss.
· Pharmacy Network: Through HCCA's partner Argus,
63,000 pharmacies nationwide, over 95% of pharmacies in the country. Argus processes claims on the level of the largest PBMs. Argus' buying power allowsHCCA to compete with much bigger PBMs, as it eliminates some of their price advantage when compared toHCCA . Due to these advantages,HCCA's new clients experience a seamless transition to the plan, as it is accepted at nearly all pharmacies nationwide. When added toHCCA's retail mail-order pharmacy, which provides steep discounts for customers while keeping all revenue in-house,HCCA's network stands at a fairly equal footing with the largest PBM's in the market. By exploiting this relationship,HCCA is able to deliver a higher degree of savings to its customers, and gain greater appeal in the contracting process due to the availability of the large network.
· Price:
claims adjudication capabilities. Argus currently processes an aggregate of over 500 million pharmacy claims a year for a number of PBM providers. Due to this substantial market presence, it is generally able to negotiate drug prices far below that which PBM's of comparable size toHCCA's would otherwise be able to. Further, there are no fixed costs associated with this network, as all payments are set up on a per-prescription processed basis.
· Unique and Innovative Programs:
o Patient Empowerment Program (PEP): This voluntary clinical management program
provides members with a cash incentive to try brand-to-generic substitutions
and therapeutic brand alternatives. PEP provides a small but worthwhile cash
payment for each switch from brand to generic.
7 . . .
Item 9.01 Financial Statements and Exhibits
Exhibit No. Description 2.1 Agreement and Plan of Merger, datedJanuary 25, 2013 , by and amongSelway Capital Acquisition Corporation ,Selway Merger Sub, Inc. ,Healthcare Corporation of America ,Prescription Corporation of America ,Gary Sekulski , andEdmundo Gonzalez (incorporated by reference toSelway's Current Report on Form 8-K datedJanuary 25, 2013 ) 99.1 Audited financial statements ofHCCA for the years endedDecember 31, 2011 and 2012 99.2 Pro-forma financial statements 99.3 Presentation datedMarch 2013 53
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