PBM Management & Procurement
PBM procurement reinvented
AlignRx’s unique procurement process provides a side-by-side assessment and comparison of each PBM. By focusing on every aspect of the partnership, our clients can choose the partner that is right for them, while also saving an average of 20% on their pharmacy benefit costs.
When you work with AlignRx, you work with a team that has over 100 years of collective experience running RFPs for employer groups and health plans. We understand that true savings is driven by strong contractual guarantees, along with effective clinical management. Our proprietary procurement process integrates all decision elements and was developed to handle groups of all sizes. Because we know better than anyone that one size does not fit all, and true success comes from customizing solutions to meet each client’s unique needs.
A focus on limiting disruption
There are a lot of strategies that PBMs use to make money on employer groups. Misrepresenting the pricing on the rate sheet is one of their main levers. To combat this, AlignRx has developed proprietary modeling which identifies any “games” within the PBMs pricing and will quantify the financial impact to the client. Our process also identifies the number of unique members which will be impacted if the client were to switch PBMs due to formulary and network compositions.
We have the largest network of PBM contracts.
By working with over 50 PBMs, AlignRx provides its clients with multiple options to ensure the right fit. Our mix includes small, medium, and large PBMs which allows our clients to find the best fit and combination of solutions to drive the highest cost savings with the least amount of disruption.
Our Approach to the RFP
With PBM contracts, the devil is in the details. AlignRx has developed an RFP questionnaire which cuts through the noise to ensure all requirements are met by each participant. We look at several areas including network discounts, dispensing fees, rebates, administrative fees, performance guarantees and more.
Request a Free Pharmacy Cost Repricing Analysis
There is no other pharmacy benefit consulting firm that offers the level of expertise in performing such complex procurement exercises, and that will get the results you can expect from AlignRx.
- 20% Average Savings
- Strict Contract Financial Requirements
- Audit Rights
- Market Check Provisions
- Ownership of the Data
- Performance Guarantees
- Termination Provisions
- Implementation Credits
World Class Implementation Support
Our team is here to facilitate a smooth transition to the selected PBM. We ensure all implementation items are completed prior to the effective date, assist the PBM and client to map current benefit design to the new benefit build out and work closely with the prior PBM to get all necessary transition files transmitted to the new PBM.
Our member-first approach proactively identifies and addresses member disruption with a white-glove transition plan and provides best in class service and support to address any member challenges throughout the year.
Continued Consulting Support
Once a new PBM has been selected and implemented, our support does not stop. Our ongoing consulting services mean that we are laser-focused at all times on your trends, utilization and opportunities for savings. We provide:
- Annual financial reconciliations to ensure all contractual guarantees are met by PBM
- Market updates on any new programs available to help reduce cost
- Detailed reporting on claim utilization, high cost claim reviews, and cost projections
Working with AlignRx, means you have a powerhouse team of pharmacy experts to conduct periodic market checks or leverage our PBM renegotiation expertise to ensure you are receiving best in class terms and pricing.
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