Stories to Savings: Read about assessments that saved our clients millions.
No-Risk Pharmacy Benefit Assessment
With pharmacy costs accounting for nearly half of total employer health care spend, it’s more important than ever to proactively manage pharmacy costs by taking greater control of PBM contract management. Our assessments are the most effective way to determine if a current PBM contract has shortcomings or if a PBM is failing to meet its responsibility to provide the highest quality pharmacy benefits at the lowest cost.
Let our experts take a deep analysis into critical areas of your PBM contract and plan performance to identify cost savings opportunities. Typical annual savings identified in our assessments range from 15% to 30% of total prescription drug costs.
How Does It Work?
An assessment does not require you to make any changes to your program. It can, however, provide you with the peace of mind that you are doing your very best to leverage finite resources. This no-risk review is the most effective way to determine if a current PBM contract has shortcomings or if a PBM is meeting its responsibility to provide the highest quality pharmacy benefits at the lowest cost.
Our reviews are not disruptive to your current PBM relationship or plan members. Findings are transparent and unbiased and the process requires very little of your time. To analyze your program, we only need two pieces of readily available information: (1) your current PBM contract; and (2) a file containing the most recent 12 months of claims.
Assessment Results
- May 6, 2023
Global Manufacturer Realizes Pharmacy Benefit Savings of $10.5 Million
Before negotiations, the client’s annual drug cost was nearly $70,000,000. The new contract reduced that cost by $10,543,000 —a decrease of close to 16%.
- July 7, 2023
Health System Saves Over $34 Million on Pharmacy Benefits
Through Innovative’s RFP process and clinical innovation, a health system realized sustained savings that totaled over $34 million.
Additional Pharmacy Benefit Consulting Services
Plan Design & Clinical Consulting
Our team of consultants will help you create plan designs that drive member behavior. Pharmacists and clinical consultants will increase your knowledge of pharmacy market dynamics and trends — and how they impact your organization.
Cost-Saving PBM RFP Process Management
Our vendor-agnostic approach allows us to deliver pharmacy benefits solutions that match clients with the services they need — at the best pricing possible. We’ll navigate the ins-and-outs of pricing and contract complexities while protecting your interests at every turn.
Pharmacy Benefit (PBM) Vendor Management
Our team of operational experts takes the burden of managing the pharmacy benefit off your shoulders. We will lead the day-to-day account management of your vendor relationship and hold the PBM accountable for operational excellence.
Pharmacy Claims Surveillance
Our team of experts continuously monitors your pharmacy benefit program performance and pharmacy claims. Leveraging data, analytics and expertise, our health actuary and financial and clinical analysts provide quarterly and an annual review of your prescription benefit program.
Medical Claims Surveillance
Our team of nurses and pharmacists manage risk by continuously reviewing the pharmacy claims that come through your medical plan. They identify opportunities to mitigate financial risk to the organization and improve the health of plan members – with little to no member disruption.