Have you ever considered for a moment that most traditional pharmacy benefit manager contracts provide access to 65,000 – 70,000 pharmacies?

But……40,000 is really just the number of pharmacies needed to serve the U.S. population.

So, what’s my point?!

The point is that traditional PBM’s, many of which now own pharmacies, will take whatever they can get. They’re interested in giving their clients, you, the plan sponsor as much access as possible. Why? They know that based on traditional, spread-based pricing they’ll have nearly endless opportunity to charge the you, the plan sponsor one price, but then reimburse the pharmacy a price less than what you were charged.

So, why wouldn’t you want to be in more control?! Control over decisions made on your behalf.

So, how do I wrestle control you ask? Very simple. The service agreement you sign with your PBM is your opportunity to gain control and transparency into terms and conditions. The agreement sets all things related to your PBM in motion – It’s your (massive) opportunity to control outcomes.

That’s the good news. The bad news is most don’t know how to dive deep enough to get past the general contract provisions. It takes a skilled eye to drill down and gain full, radical transparency.

If you’re interested in this concept of transparency and want to learn more, I’m happy to share more on the work I do through our ApexRx program.  DM me via LinkedIn or slong@apexbg.com.