The Employer's Guide Blog for Overseeing PBMs

The Definition of Oversee: to watch over and direct (an undertaking, a group of workers, etc.) in order to ensure a satisfactory outcome or performance.

Industry Consolidation Is Impacting PBM Customer Service

Drug Benefit News interviewed several pharmacy benefit consultants about what employers are seeking in a pharmacy benefit manager, and found that although shopping around for a new PBM is a hassle, some employers are considering it because they’re unhappy with the customer service at their current PBM.
“I think [PBM industry] consolidation has impacted the quality of service on clients,” asserts Helen Sherman, Pharm.D., vice president at Solid Benefit Guidance. Some of these “service pains” created by recent mergers and acquisitions pertain to resolution on coding and other operational issues, she tells DBN.

“Our large employer clients have been particularly interested in exploring the marketplace this year,” reports Josh Golden, a consultant at Pharmaceutical Strategies Group LLC. “This is driven by two primary factors: First, inconsistent service levels across the major PBMs have left a number of clients frustrated with their incumbent.

Second, our clients are learning that the competitive bid process almost always drives a better financial outcome compared to a non-competitive renewal. They’re willing to invest time and resources to pursue that additional value.”
Visit to read the article in its entirety, including what consultants have to say about carve-in deals.

Tyrone Squires, MBA, CPBS

I am the proud founder and managing director of TransparentRx, a fiduciary-model PBM based in Las Vegas, Nevada. We help health plan sponsors reduce pharmacy spend, by as much as 50%, without cutting benefits or shifting costs to employees.

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