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.

The Pharmacy Benefits Manager RFP; 7 Contract Tips for a Cost Efficient Drug Benefit Design

  1. Skip the RFP as it is largely a waste of time and money. Instead draft an airtight FIDUCIARY contract and put it out for bid
  2. Acquire “reference pricing” AND relentlessly measure cost performance 
  3. Write meaningful financial and performance guarantees 
  4. Mandate full transparency and complete audit rights 
  5. Create market check and carve-out rights that currently don’t exist in almost all PBM contracts 
  6. Shorten contracts (to 2 years) and include favorable contract termination rights 
  7. Eliminate rebate and/or savings program loopholes

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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