Pharmacy Benefits Consulting

Walmart recently released its own brand of analog insulin for people with diabetes to boost its pharmacy business and compete with Amazon’s recent push to sell more medications.

If you’re managing a self-funded healthcare plan in 2021, chances are you know about specialty medications and how they can devastate a pharmacy benefit budget. Specialty drugs are becoming more common, so your organization needs to have a plan for …

What is spread pricing? It’s how PBMs make money at the expense of you paying more money for your prescription drugs. Apex Chief Operating Officer Jim Harenberg gives an example of spread pricing and why customers should combat it in …

Jim Harenberg, Apex Benefits COO, discusses what 10-30% savings on pharmacy benefits means to your company in real dollars.

This new search tool includes pricing of 60,000 pharmacies across the US, according to the blog post and link above. Naturally, as a pharmacist, I was curious so I took this search tool for a test drive today to check …

While some individuals and their employers have obtained medications through personal importation that appear to reduce the drug’s cost, the savings results are not universal and there are other considerations that as a pharmacist I think every employer and their …

Apex Benefits, Indiana’s largest employer health benefits advisory firm and services provider, is proud to announce the addition of two more employees to its Kinetiq Health team of Certified Pharmacy Benefits Specialists. Advisor Mark Goodpaster and Senior Account Executive Joni …

Chances are if you manage a self-funded health plan, you know how important specialty meds are to your overall costs. The complex administration of these high-costs drugs can be intimidating. But as an HR administrator, you shouldn’t be as there’s …

What you’re looking for is referred to as “lessor of” logic or “lessor of” language. In layman’s terms, its language in your PBM contract that stipulates that if there is a lower available price, the PBM must use it as a …

Less is more, right? When it comes to pharmacy benefits, this is absolutely applicable. It’s called Lesser of Language, or language in your PBM contract that instructs PBMs must use the lowest price of a drug on the market when …

Of course, you need to know where cost is coming from. But, equally important, you need to understand where cost is not coming from too so that you can reduce avoidable costs.

I’ve got a question, have you ever caught yourself forgetting what an acronym stands for? Seriously – It happened to me this past weekend. Acronyms are all around us.