Many plan sponsors assume annual market checks are built into their PBM contracts, but that’s not always the case. Without explicit language in your contract, it’s nearly impossible to know if your guarantees, rebates and pricing remain competitive in today’s fast-moving market.

Pharmacy costs and contracting norms change fast. With the introduction of new drugs, evolving rebate structures and ongoing PBM consolidation, even contracts that are only a couple of years old can quickly become outdated. While issuing an RFP every year may seem like the solution, it’s often disruptive, time-consuming and unnecessary when a well-structured market check can provide the insight you need.

What’s in a Market Check?

A market check is a comprehensive, data-driven review that compares your current PBM contract terms to today’s market standards. Your consultant validates your data, benchmarks performance across multiple PBMs, identifies gaps and provides PBM negotiation support when needed to ensure your plan is getting the best value possible.

Why a Market Check Matters

With a market check, you confirm your plan’s competitiveness, demonstrate your fiduciary diligence and ensure your pharmacy benefits plan is delivering as expected—all without the disruption of changing vendors.

Bottom line: Market checks keep your PBM accountable, your pricing competitive and aligned with today’s market, and help you meet your fiduciary responsibilities. Contact us to learn more.