Innovative Solutions. Maximum Value.

We have your back when it comes to realizing the greatest value for your benefits investment.

Innovative Pharmacy Benefit Plan Design & Clinical Consultation

We take a consultative approach to customizing pharmacy benefits plans that strike a balance between pharmacy cost containment, patient utilization and accessibility, and optimal patient health outcomes.

Blending pharmacy industry experience and pharmacy benefits know-how with best-in-class analytics, we serve as an independent advocate in maximizing the value of your program to your members. Our pharmacists and clinical consultants will identify the plan design options, clinical programs, and specialty pharmacy alternatives to help you meet your business goals.

Strategies & Solutions

  • Customization of formulary to drive to lowest net cost utilization
  • Management of specialty drugs
  • Carve-out of specialty pharmacy to PBMs focused on specialty drug utilization
  • Maximization of generics through plan design
  • Biosimilar strategies
  • Optimization of rebates — when it makes sense
  • Vetting of all third-party pharmacy program offerings
  • Updates on new drugs to market
  • Evaluation and updates on impact of market trends
  • Updates on impact of pharmacy and pharmacy benefit legislation

Additional Pharmacy Benefits Consulting Services

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.

Pharmacy Benefits Plan Assessment

Take control of your pharmacy benefits plan expenses by taking advantage of a no-cost, no-obligation savings assessment. With your current pharmacy benefit management contract, and a file containing your most recent 12 month of claims and rebates, our team can determine if the highest quality pharmacy benefits are being received at the lowest cost.

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