Learn to spot those differences so you can make informed choices for your pharmacy plan.
Coalitions
- Work with Pharmacy Benefit Managers (PBMs) to manage pharmacy benefit plans
- Trust the PBM to provide terms with the best rebates, formularies, and drug prices
You spy: Aggregate power to negotiate competitive drug prices
We spy: Contracts that offer low prices, but not always the lowest net cost
Pharmacy Benefit Managers (PBMs)
- Administer prescription drug benefits
- Manage formularies, claims, and prior authorizations
You spy: A partner working with manufacturers and pharmacies to negotiate drug prices
We spy: Profit drivers generating revenue from sources like rebates, spread pricing, and proprietary pharmacies
Pharmacy Benefit Optimizers (PBOs)
- Work with PBMs and clients to manage plans to the lowest net cost — not just lowest price
- Independently manages formularies, claims, and prior authorizations
- Provide on-the-ball, responsive service to employers and members
You spy: Aggregate power to negotiate client-aligned contracts
You spy: Client drivers, with revenue generated from program fees and client savings
You spy: Plan management, clinical management, and service all in one place
Getting the most out of your self-funded plan is all in the details. Contact RxBenefits today to help you spy client-aligned contract terms, clinical management, and service in your pharmacy plan.
