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Rx Solutions

Marsh McLennan Agency’s pharmacy specialists provide data-driven solutions and ongoing program management to help you improve the vitality of your pharmacy contract.

Rx Solutions delivers significant savings by focusing on contract language, clinical and formulary management strategies, and employee purchasing trends. Whether your plan is carve-in or carve-out, Rx Solutions uses advanced clinical analytics to support you with recommendations for program changes, member engagement, and savings opportunities—while striving to optimize pharmacy benefits.

15%

average employer savings

$500

million in total client savings

100+

years combined pharmacy expertise

Benefits of Rx Solutions

We create innovative and measurable solutions that improve your pharmacy arrangement and bring clinical effectiveness to your formulary.

  • Improved cost and trend management
  • Client-centric pricing and contract terms
  • Client-first focus during negotiations on pharmacy contracts
  • Innovative pharmacy management solutions through an unbiased and independent pharmacy practice

 

Rx Solutions Features

Rx Solutions works in partnership with your benefits team, pharmacy benefit manager (PBM), and finance team to support program strategy, drive member engagement, and create savings.

8-Point Analysis

Uncover additional savings opportunities and offer greater control over future Rx strategies.

Contract Language Adjustments

On average, our contract language adjustments save clients 7% on their pharmacy spend.

Specialty Drug Management

Manage the high cost of specialty drugs with pinpointed strategies based on clinical insights and data analytics.

Meet Rick, a specialist in pharmacy benefits.

Rick Kelly

Senior Vice President
Raleigh, NC

Frequently Asked Questions

To fully understand the role of a pharmacy benefit manager (PBM), you need to consider the processes involved in determining prescription drug costs.

In general, the pricing of a prescription drug that patients buy can depend on a number of factors, from the drug manufacturers producing them to your insurer’s negotiated conditions, and the chosen PBM. The final drug prices will be influenced by the formulary in your health plan and supplementary benefit programs. Prices are also influenced by the list of covered specialty drugs and conditions negotiated with the manufacturer, including a potential rebate.

The entire process requires you to stay up to date on a range of ever-changing conditions and collaborate with different business partners, from pharmacy networks to health insurers. That’s where PBMs come in. Their experience with legal details, contract conditions, and common drug pricing patterns allows them to function as an intermediary between you and the pharmaceutical market. This can result in significant cost savings for you.

Since they serve clients such as yourself regularly, they can also use their leverage to negotiate better contract conditions with suppliers. That means they can offer discounted prescription medications and save money by analyzing your existing contracts and renegotiating with manufacturers.

While a pharmacy benefit manager and your insurance company fulfill organizational tasks in dealing with your prescription drugs, they are not the same.

In the case of your prescription medications, your insurance company first assesses risks and the medical needs of those involved. Then, the insurer charges an insurance rate that reflects its risk assessment to provide coverage for potential treatments and drug costs or additional expenses resulting from loss of income as part of a comprehensive health insurance package.

The pharmacy benefit manager, on the other hand, serves a tiny niche of that broad health care offering. They negotiate the conditions between each medication manufacturer and insurers. Later, the PBM is also involved in processing and paying prescription drug claims.

So when evaluating your PBM’s effectiveness it’s crucial to have objective measuring points to evaluate their performance over time. In most cases, you’re looking for more cost-effective medication, access to higher tiers in your health plan, or faster admission to the appropriate therapy. Sometimes, these offerings may be combined with specialist consulting services, contract reviews, or formulary optimization.

As a result of their experience in contract audits and specialty medication management, pharmacy benefit managers can reduce friction and cost, in terms of time and money. When comparing your options, look for rebates, guarantees, eligible claims, and access to your PBM’s data.

How you benefit from a PBM through reduced pharmacy costs will ultimately depend on the negotiated conditions, your medical situation, and your drug formulary. For instance, you might be able to lower your co-payment if a health care professional decides to include an exception in your Medicare plan based on their prior diagnosis.

Meet a rx solutions specialist.

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