The PBM Industry is rapidly changing. While your choices in the past were few, today, an extensive array of possibilities is available to lower your drug costs and improve your drug benefits, if you obtain knowledgeable consulting and legal advice.
Small PBMs are creating dynamic, new marketplace alternatives. Large PBMs are struggling to compete by decreasing their costs and offering new benefit programs (only a few of which will improve your drug benefit coverage). The time to evaluate – and improve – your prescription coverage is now.
Pharmacy Benefit Consultants can assist you in dramatically reducing your drug benefit costs, while simultaneously expanding your drug benefit coverage:
- Conduct A “Request for Proposal” (”RFP”) To Select A New PBM From Among Numerous PBM Contestants, But Conduct the RFP Differently. During their RFPs, other consulting firms largely — or entirely — ignore the one thing that matters most to your benefits and costs — your next PBM contract. We don’t do so. Given our legal expertise, we conduct RFPs differently, and use the RFP’s leverage to draft, negotiate and finalize a new form of PBM contract during our RFPs. As a result, our clients have a fully-negotiated new contract to execute on the day they conclude their RFPs, and our clients experience dramatically lower costs when they implement their new contracts.
- Obtain A Detailed Analysis of the Weaknesses of Your Current PBM Contract. In so doing, you will position yourself to understand why your costs are so high. You will also be able to renegotiate your entire contract to eliminate all contract terms that PBMs are using to drive up your rx coverage costs, and to replace those terms with an entirely different form of PBM contract.
- Contractually Require Your New PBM To Renegotiate – At Least Annually – All Pricing Terms and All Guarantees. In so doing, you will ensure that your health plan receives the best financial terms available in the marketplace — throughout the life of your contract — rather than being stuck with contract terms that have become obsolete only months after your contract is implemented.
- Use Our Claims Data “X-Ray” To Obtain A Quick And Inexpensive Understanding Of Your Current Claims Data and Resulting Costs. Rather than wasting a large amount of money auditing your current contract, which is undoubtedly stuffed with loopholes and ambiguous language that will preclude any serious recovery, ask our firm to provide a quick and far less expensive “X-Ray” of your recent claims data. By doing so, we can determine your actual costs — focusing in particular on the costs of commonly used drugs — and let you know how much you can save if you obtain an airtight, competitive PBM contract.
- Learn About Other New Cutting-Edge Strategies To Decrease Your Drug Coverage Costs, and Improve Your Drug Coverage Benefits.
Contact Pharmacy Benefit Consultants for further information.