PBM Contract Analysis & Negotiation

Every year, hundreds of entities — private corporations, unions, insurance companies, government bodies and coalitions — enter into new contracts with Pharmacy Benefit Management companies. Unfortunately, virtually all of these contracts are riddled with the identical contract “loopholes.”

As a result, PBMs are able to manipulate the contracts, deprive their clients of millions of dollars in savings, and continuously drive up their clients’ costs throughout the contracts’ durations.

Drafting an effective PBM contract requires two “tools”: (i) a thorough understanding of all the methods that PBMs use to manipulate their contract terms; and (ii) the legal skills to draft an “airtight” legal contract that will eliminate all PBM contract “loopholes.” Few who are drafting PBM contracts have both of the above. Most have neither.

Pharmacy Benefit Consultants has written and published articles to assist all plans in understanding the likely deficiencies in their PBM contract. We urge your plan to download our materials – for free – and study their contents in the privacy of your office. When you do so, you will be taking the first step toward dramatically decreasing your prescription coverage costs.

Download: “How To Eliminate PBM Contract Loopholes”

Download: “Don’t Get Trapped By PBM Rebate Labeling Games”

Download: “Don’t Get Caught By PBMs’ MAC Mousetraps”

Additional articles can be found on our Website’s Videos and Articles page.

Not sure you know how to apply the learning from our articles to your contract? Contact us, and we’ll walk you through your contract, and help you understand its weaknesses and what must be changed.

We have provided scores of entities with such consultations, and without exception, virtually all have stated they were astonished to discover the weaknesses in their contracts. More important, the plans that have taken the steps to correct their contract deficiencies have dramatically decreased their prescription coverage costs.