Helping You Solve Pharmacy Benefits Challenges Today While Getting You Ready for Tomorrow
RxBenefits partners with benefits advisors/brokers to help mid-market self-funded employers save significant dollars on pharmacy benefits, lower their risk of catastrophic specialty claims, enhance the health and safety of members, and provide a world-class benefits experience.
Big-Company Leverage in the Hands of Mid-Market Plan Sponsors
No employer should have to settle for a plan that doesn’t suit their needs. But how can a benefits advisor help a mid-market self-funded employer secure a pharmacy arrangement that rivals that of the nation’s largest companies? That’s easy! RxBenefits wields the purchasing power of a Fortune 10 company, attracting the attention of the nation’s leading PBMs who actively compete in our marketplace for our clients’ business. As a result of this negotiating power, we’re able to deliver 12-month contracts with market-leading pricing and transparent, client-aligned terms. Add to those annual reconciliations and automatic year-over-year pricing improvements, and you’ve got yourself a pretty sweet deal.
So next time you think you don’t have the size, scale, or expertise to demand what you need and deserve from the PBMs, know that’s okay. You can always borrow ours.
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A Tailored, Flexible Direct-to-PBM Contract Arrangement
For employers that prefer to contract and work directly with the PBM for services, RxBenefits still offers the benefit of our superior negotiating power to drive cost down. We apply our Fortune 10 size, scale, and expertise to negotiate a leveraged 36-month, client-aligned, PBM-held contract for plan sponsors. In addition, our expert advisors provide oversight over the life of the plan to make sure the PBM is delivering fully on its commitments.
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Independent Clinical Oversight and Intervention for Better Outcomes
To ensure a healthy bottom line and the health and safety of their employees, an employer needs a pharmacy benefits partner who’s focused solely on doing what’s in the best interest of the plan and its employees – not making decisions that drive profits for the PBM. RxBenefits independent team of licensed PharmD’s operates free from influence by any PBM or carrier to ensure members always get the safest, most clinically appropriate, and cost-effective medication for their condition. Leveraging chart notes and medical records, along with well-established clinical best practice and guidelines, they make independent prior authorization decisions that ensure the best of care at the lowest possible cost. This team provides broad oversight of the plan, while focusing on the plan’s most vulnerable members with the most expensive medications.
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Preferred Patient Assistance Solutions
Specialty medications account for just two percent of overall drug usage, but 50% (and rising) of the total pharmacy benefit cost. RxBenefits preferred Patient Assistance solutions help companies provide needed specialty medications to their employees while remaining fiscally responsible. Combined with Protect, this proprietary suite of clinical oversight programs,Patient Assistance solutions help employers save money by tapping into available assistance dollars to provide members access to appropriately prescribed, high-cost specialty medications.
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A New Solution for Surviving Catastrophic Specialty Claims
The growing challenge of large and catastrophic specialty pharmacy claims calls for a new, innovative solution. Offered through our sister company and sold through licensed advisors, RxPharmacy Assurance is pharmacy-only stop-loss insurance to provide added protection above and beyond traditional stop-loss coverage, so employers never have to worry about the danger of a very high-cost specialty drug claim threatening their financial health.
Visit RxPharmacyAssurance.com