As the situation in Ukraine evolves, businesses should be mindful of potential risks to their people, assets, operations, or supply chains in the region and globally. Marsh, as part of the Marsh McLennan family of companies, has created a page with information, tools, and resources related to the Russia-Ukraine conflict. Please visit the page for the latest information.

June 23, 2022

How to leverage a pharmacy partner and optimize your PBM contract

The world of pharmacy can be complicated without someone knowledgeable to help you navigate it. Providing your employees with the most effective program starts by having the right partner. Having the right partner with your organization’s best interests at the forefront, knowing the right questions to ask, and being up-to-date on the ever-changing pharmacy landscape are vital to a functioning pharmacy plan.

Pharmacy plans often use a pharmacy benefit manager (PBM). As the administrators of the pharmacy world, PBMs negotiate rebates and discounts from drug manufacturers and the prices paid to pharmacies where members fill their prescriptions. They also set the preferred drug lists (known as formularies), adjudicate pharmacy claims, and often perform the utilization review that determines which drugs are clinically appropriate for a member. While PBMs are an important part of the pharmacy landscape, their contract language can at times be difficult to navigate.

This is where a pharmacy partner comes into play. Along with your legal team, they can help you navigate the nuances of these contracts and help you negotiate an agreement that can be the most beneficial to you. While holding your PBM accountable throughout your journey and maintaining a reasonable contract, a pharmacy partner can also initiate financial performance audits to ensure the plans you are providing are working as intended.

Rx Solutions, powered by Marsh McLennan Agency (MMA), has the tools, insights, and expertise you need in a strategic partner. Focused on your goal of delivering equitable and cost-effective pharmacy benefits, they provide the following services to make sure you reach that goal:

  • Contract procurement and management
    • Procurement services
    • Contract review and audits
    • Plan refinement
    • 360 Oversight
  • Advanced Rx interventions
    • Clinical Rx program review
    • Specialty drug management
    • Formulary optimization
    • Condition specific management

With MMA Rx Solutions, you receive a dedicated team focused on improving the vitality of your pharmacy arrangement with little to no disruption to your employees. Providing customizable solutions that fit whatever your needs may be and adapting those plans as your organization grows is necessary for a tense prescription drug market.

To find more information on MMA Rx Solutions and how to contact an MMA specialist, please visit us here.

 

This document is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. Marsh & McLennan Agency LLC shall have no obligation to update this publication and shall have no liability to you or any other party arising out of this publication or any matter contained herein. Any statements concerning actuarial, tax, accounting or legal matters are based solely on our experience as consultants and are not to be relied upon as actuarial, accounting, tax or legal advice, for which you should consult your own professional advisors. Any modeling analytics or projections are subject to inherent uncertainty and the analysis could be materially affected if any underlying assumptions, conditions, information or factors are inaccurate or incomplete or should change. Copyright © 2022 Marsh & McLennan Insurance Agency LLC. All rights reserved. CA Insurance Lic: 0H18131. MarshMMA.com