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.

Rare Look: A Detailed Analysis of an Existing Client’s Old Contract with a Legacy Pharmacy Benefits Manager

With permission from an existing client, I’ve provided here an example of a bad PBM contract. This section of the contract pertains only to pricing or client payments. Nevertheless, client payments are the foundation for a successful PBM program. Read the red font. It provides a detailed analysis and explains why this contract is bad for the payer (a self-funded employer group with over 5000 members) yet very profitable for the PBM.

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Do you want to eliminate overpayments to PBMs now? The fastest path to pharmacy benefits cost containment starts here.

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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