WE ARE ON YOUR SIDE.

There are two things we know for certain. Most purchasers of PBM services are satisfied with the service levels they receive, but are concerned with the escalating cost of maintaining a pharmacy benefit. Second, the very best way to control pharmacy costs is to become a better more sophisticated steward of the pharmacy benefit. TransparentRx’s focus is on helping you reduce PBM management fees by as much as 50% without cutting benefits or shifting costs to employees.

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HOW WE PULL IT OFF

Most pharmacy benefit managers generate enormous revenues by keeping their clients’ heads in the sand. Unlike our competitors, TransparentRx profits when our clients’ heads are lifted out of the sand and into the light. You’ve heard all the promises from PBMs only to learn once the ink is dry on the contract that they are not as upfront about hidden costs as you had hoped. Well, do you know of any PBM willing to take fiduciary responsibility related to their PBM contract? You have now. For the record, if a PBM claims to accept a fiduciary relationship and just nine or ten sentences are dedicated to it, in the contract, that PBM hasn’t come close to meeting the disclosure and transparency load a true fiduciary carries. Look closely at our client onboarding process just below.

  • Certified Pharmacy Benefits Specialist (CPBSTM) program, 1st of its kind
  • Earn up to 16 continuing education credit hours for pharmacists, pharmacy technicians, HR professionals and L&H licensees nationwide
  • Three classroom options: eLearning, On-site and Off-site workshops
  • No or low out-of-pocket costs; employer may pick up portion of the costs
  • Employees – stay competitive in the workforce and raise your professional value
  • Employers will benefit from having well trained in-house leadership for managing pharmacy benefits
  • Employers should be educated and work directly with PBM

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  • Plan Performance Assessment Report (PPAR) – designed to thoroughly examine your PBM’s financial performance, contract and plan design
  • Comprehensive Audits
  • Rebate Audits
  • Performance Guarantee Reviews
  • Implementation Audits
  • Plan Design
  • Vendor Selection – Reverse Auctions & RFP Support
  • Contract Analysis & Renegotiation
  • Formulary Management & Customization
  • Medical Consistency
  • Continuous PBM Monitoring
  • Fraud and Abuse

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  • Acceptance of fiduciary responsibility
  • Retail network consists of 66,000 pharmacies
  • Home Delivery
  • Specialty Pharmacy
  • Disease Management Programs
  • Real time web-based reporting
  • Performance Guarantees
  • Dedicated Client Services Professional
  • Medication Therapy Management (MTM)
  • Population Health Management
  • Claims Adjudication
  • Customized Drug Formularies
  • Demand Management
  • Utilization Management
  • 24/7 Call Center

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MEET THE LEADERSHIP TEAM

The pharmacy benefit version of the “fee-only financial adviser” has emerged in response to a desire among certain pharmacy stakeholders to bring radical transparency to the drug pricing process. Although all PBM contracts with clients are viewable by both parties, PBMs operating under a traditional model often employ contractual wording that allows for pricing and reimbursement mechanisms that render clarity of expenditure and actual cost drivers to be elusive, and are designed to maximize the overall margin or mark-up for the PBM.

Tyrone Squires,
MBA, CPBS

Managing Director (See Bio)

Andrea Harlow,
CPhT, CPBS

Director of Implementation (See Bio)
Victoria Spradley

Victoria “Vicky” Spradley,
CPhT, CPBS

Director of Account Management (See Bio)

Rishi Kalia,
B.S. Computer Science

Director of Information Technology (See Bio)
izabela

Izabela Niezborala,
PharmD

Director of Pharmacy Services (See Bio)

Matthew GoldSmith,
PHR

HR Manager (See Bio)

Under TransparentRx's fiduciary model, contracts negotiated between us, clients, and pharmacies are designed to be as understandable and transparent as possible which, ostensibly, is meant to encourage the best therapeutic outcomes and financial interests for our clients. There are fewer inherent conflicts of interest under a fee-only fiduciary model and no additional margin gained from favorable tier placement on high-cost/revenue drugs. Our leadership team is relentlessly focused on eliminating wasteful Rx spending without sacrificing healthcare outcomes.

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