What We Do

Prescription drugs are one of the most complex aspects of employee benefits. To maximize your drug program’s effectiveness and minimize the drain on your bottom line, our team helps you manage the impact of escalating pharmacy benefits costs by increasing the transparency and terms of Pharmacy Benefit Management (PBM) contracts.

We find savings because we know where to look. And we know how to ensure discounts, rebates and other manufacturer-derived revenues pass through to the ultimate funders of healthcare – the employers – instead to the PBMs’ profit margins.

HOW WE’RE DIFFERENT

We offer the most experienced pharmacy benefits consulting team of any Indiana-based benefits advisory firm. Our team of Certified Pharmacy Benefit Specialists (CPBS) conducts PBM contract assessments to identify cost saving opportunities that can translate into additional revenue for your organization. With our experience we’ve been able to save our clients an average of 50% on their Rx benefits costs – without shifting costs to employees and with zero or very few disruptions to their benefits plans.

Pharmacy Benefits Consulting

Services

Uncover Found Revenue Through Savings

CONTRACT HEALTH ASSESSMENTS

Our CPBS team will review your PBM contract to assess its strength and transparency and assign a score from A to C. With your contract health score in hand, our team audits your entire Rx benefits program to identify cost-saving opportunities.

SOURCING & CONTRACTING

Once the contract assessment is completed and action plan determined, the team sources better pricing from the current or new PBM companies. The team also ensures the commitments made are written into a strong, transparent PBM contract.

IMPLEMENTATION

Working with the PBM, third-party administrator and your team, we will guide your plan implementation from set-up to go-live. We work with you and your employees to manage the transition and minimize any potential disruption.

CUSTOMIZED MONITORING

Monitoring is a crucial tool to ensure you get what you pay for. We offer a range of customized reporting, analysis, market check/monitoring and audit services to make sure the pricing and performance of your pharmacy benefits remain aligned with the contract terms.

Pharmacy Benefits Consulting

How Much Could You Save?

*Depends on your current contract and benefit design, covered population, medication mix and current market pricing.

  • Input total expense for pharmacy claims in given year.
  • Please enter a number from 10 to 30.
    Input potential savings percentage (Apex Pharmacy Benefits clients may expect 10-30% pharmacy savings in the first year).

High-Cost Rx Event Recap

Global Rx Experts Share Knowledge

Employers understand that a diagnosis of cancer or a debilitating chronic disease among their workforce could result in the need for lifesaving, high-cost medications that can wreak absolute havoc on their organizations’ finances. Event attendees wanted to be better informed — and better prepared — for managing their risk. View the page linked below for thought leadership and practical tips from executives from Eli Lilly, Cigna/Express Scripts, SwissRe and Apex.

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Pharmacy Benefits Consulting

PHARMACY BENEFIT SAVINGS

$150,000 Potential Reduction in Rx Claims

As a self-funded organization, the rising cost of providing healthcare benefits was creating a financial challenge for a company with several employees who required high-cost drug regimens. A potential savings of 43% of the previous year’s Rx spend was identified.

View Case Study
Pharmacy Benefits Consulting

Recent Posts

  • July 16, 2021

    The Perfect PBM: Does it Exist?

    The perfect PBM does not exist, because no PBM might be perfection. However, that is unrealistic knowing that there are more than 20,000 prescription drugs on the market at any one time, more than 65,000 retail pharmacies out there in …

  • July 13, 2021

    Better Benefits in 90 | Kinetiq Health Pharmacy Benefits Consulting Program

    Does your organization take an active approach to saving money through its pharmacy benefits program? You’d be surprised at the potential cost saving opportunities that exist. At Apex, our Kinetiq Health Pharmacy Benefits Consulting Program just does that — save …

  • July 9, 2021

    Walmart’s Life- and Cost-Saving Insulin

    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.