How to choose the right pharmacy benefits manager

The right PBM can drive employee satisfaction and cost control. Corporate Synergies discusses the questions to ask when vetting potential pharmacy benefit managers.

By John Crable, Senior Vice President, Corporate Synergies
August 1, 2016

Group employee benefits managers are often pulled in two different directions. They’re under pressure to create an increased level of employee satisfaction while simultaneously keeping costs under control. This is obviously not easy; if you’re reading this you probably already know how difficult it can be to accomplish both objectives.

Pharmacy benefits are typically the most utilized benefit by plan members and one of the fastest-growing in terms of cost. Consequently, selecting the right pharmacy benefit manager (PBM) is a critical decision in managing a plan and supporting member satisfaction with that plan.

There’s a level of frustration among employers and group employee benefits brokers with regard to transparency among PBMs. One way some PBMs have tried to combat this frustration is through transparent pricing, meaning they don’t markup prescription prices. Instead, the PBM will charge an administration or processing fee, but this doesn’t necessarily create cost relief for the employer. Another problem with so-called transparency pricing is that net cost is far more important. In other words, transparent pricing doesn’t guarantee it’s the lowest price. Furthermore, pricing doesn’t matter if you’re not managing the plan properly. Clearly, it’s difficult to navigate this maze of pricing and value…

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