Do you know that 99% of Pharmacy Benefits Management contracts are not fiduciary in nature and therefore the PBM does not have a legal obligation to align its financial interests with your organization?
Some contracts are written so poorly that after signing the contract, you are not allowed to see the contract again. Even the top benefits attorneys in the country have an extremely difficult time identifying the hidden revenue streams in PBM contracts.
Fortunately, our firm has the knowledge and expertise to ensure that your PBM contact is aligned with your financial interests. If you are not receiving 100% of the rebates, you have a poor contract. If you are receiving 100% of the rebates, what’s the spread (different between what the plan pays and what the pharmacy reimburses)? What other hidden revenue streams have been built into the contract to make up for the fact that you are receiving a higher percentage of the rebates? Does your contract specifically state that it’s a Fiduciary Contract, meaning the PBM has a legal obligation to act in your best interests? If not, you will continue to overpay. There are many other factors to consider. Contact us for more information.