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Analyzing Your Pharmacy Benefit Program Could Save You Money

Employee Benefits

When was the last time you reviewed your company’s pharmacy program?  If you’re like many employers, you’re not aware of the terms of your Pharmacy Benefit Management (PBM) contract, especially because many are in place for years without evaluation or a market check.

As an employer, it’s important to ask yourself these questions:

  • Do I know the terms of my Pharmacy Benefit Management contract and if they are optimal in today’s market? (If your medical carrier is managing your pharmacy benefits, you may not be privy to the specific contract terms. And unless you have effectively negotiated the terms, significant savings are possible.)
  • Do I have a PBM contract that guarantees pricing terms and rebates?
  • Is it auditable, with a recovery process for any shortfall in performance?
  • Am I confident that specialty drugs, like those for hepatitis C, are being properly priced and managed by my current provider?

If you answered “no” to any of these questions, it makes sense to perform a review or audit of your pharmacy spend, and M3 is here to help.

Our pharmacy analysis and audit process can help identify significant savings opportunities. In fact, on average our clients have saved 16% on their annual pharmacy programs, in some cases without changing PBMs. This represents $22M in savings across nearly 140,000 member lives analyzed.*

Remember, if you haven’t performed a review of your PBM arrangement in the last 12-18 months to determine if it’s performing properly, you’re likely missing out on a tremendous savings opportunity. Contact your M3 account executive to find out how we can assess your pharmacy options at no cost to you.

* Clients are specific to C2 Solutions, an equity-owned partnership powered by six independent regional employee benefits firms – including M3 – coming together to deliver a national footprint.  Learn more about C2 Solutions.

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