The Situation

A large Florida public school’s Pharmacy Benefit Manager (PBM) contract was up for renewal through a vendor owned by a large insurance carrier. The existing vendor proposed a multi-year renewal of their contract with no pricing changes . 

The Solution

FBMC Benefits Management, Inc. recommended a benchmarking evaluation of 3 Pharmacy Benefit Manager options for mail order, formulary, retail network, and plan design. FBMC recommended requesting 12 months of the client’s Rx claims (client had audit rights in their current ASO contract), then benchmarking this 12 months of Rx spend by running alternative pricing and rebates across the 3 leading PBMs in the industry with one of our PBM consulting partners.

The Results

• Through benchmarking, FBMC documented a targeted Rx savings range
  $SOOK+ across each of the 3 alternative PBMs.
• The large insurance carrier was compelled to significantly change their pricing due to the competitive process.
• Although the client remained with their existing vendor, they now have a projected annual Rx savings impact of $SOOK per plan year.