Pharmacy Benefit Consultants provides the following services to clients: 

  • Conducting PBM RFPs (Requests for Proposal)
  • Analyzing existing PBM-client contracts
  • Drafting and negotiating new PBM-client contracts or contract amendments
  • Conducting in-depth claims data analyses to provide recommendations for – and calculate the savings that will result from –
    • Changing and improving a Plan’s Benefit Plan Design
    • Excluding certain high-cost drugs that have far lower-cost substitutes
    • Implementing customized prior authorization, step therapy, mandatory generic and quantity limit programs
    • Creating a limited or preferred retail pharmacy network
  • Performing audits
  • Providing ongoing and continuous clinical and financial services by regularly and continuously analyzing claims data, as well as responding to key marketplace changes such as –
    • High-cost brand drugs that lose their patents
    • The FDA’s approval of new-to-market drugs, particularly high-cost specialty drugs
    • Changes in the prices of every drug