New PBM Procurement Drives Significant Savings for Employer Group

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CLIENT PROFILE
  • 1,200
    Integrated Members
  • $1.6M
    Annual Plan Costs
  • 18%
    Drug Trend
WHAT WE DID
  • Implemented robust contract with performance guarantees and audit rights
  • Minimized disruption and member impact
RESULTS
$400K or 24% Annual Savings for the Client
Heading Style

AlignRx worked with a 1,200 member employer group to provide expertise and guidance in their efforts to procure a new PBM contract. Our team of pharmacy consultants met with the client and their benefit advisors to discuss and help identify their specific needs. We performed a comprehensive assessment of the claims files and existing PBM contract, followed by a strategy session to determine what opportunities might be missing from the current contract. 

Working together with the client, we were able to develop a specific set of criteria for the RFP, which focused on every aspect of the partnership, including financial and clinical questions, performance guarantees, and operational information. We then strategized with the client to determine which vendors to include based on their specific needs and objectives. Our team performed a precise vetting process during the RFP process to ensure that the responses were accurate and the results were comparable and quantifiable. We were then able to perform a savings analysis to understand each vendor’s value and competitive advantages and ensure they received the best economic and contract terms. In addition to the financial exhibits, we also performed a formulary and network disruption analysis associated with each vendor for the client to fully understand the member impact as it pertained to each vendor. 

Once the client made their PBM selection, AlignRx was able to leverage their industry expertise to create the best possible contract terms, helping implement a more robust contract with better performance guarantees and updated audit rights. Our independent overview and innovative procurement process allowed us to help this broker pair the client with a partner best aligned to serve the group’s needs in the complex and continually evolving pharmacy landscape. The resulting savings for the client totaled $400,000 or 24% annually.

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