When it comes to healthcare benefits, few expenses have as significant an impact on the bottom line as pharmacy costs. Employers and brokers understand the critical role that Pharmacy Benefit Manager (PBM) contracts play in driving healthcare accessibility. However, the complexity of these PBM agreements can make them challenging to navigate, leaving plan sponsors unsure about how to secure the most favorable contract terms.
The importance of understanding PBM contracts
The nuances of complex PBM contracts can have significant negative financial implications for organizations, who might end up paying more than they should for their pharmacy program. It’s critical that both brokers and plan sponsors understand the relevant elements of pharmacy contracts to drive better pricing and transparency.
This eBook, part 1 of the PBM contracting series, offers brokers and employers a clear understanding of the terms, clauses, and pricing structures that shape these agreements. With this knowledge, you’ll be better equipped to secure competitive contracts, manage costs efficiently, and deliver quality pharmacy benefits to your members.
Explore Key PBM Contract Terms
What’s inside the Guide to PBM Contract Terms For Pharmacy Benefits eBook?
Truveris’ Guide to PBM Contract Terms For Pharmacy Benefits is your detailed guide to approaching PBM contracts, offering insights into critical pharmacy contract terms. In the eBook, we outline 7 contracting terms, and for each term, you’ll find:
- Term Definition: Explains the contracting term and its impact on PBM contracts.
- Potential Challenges: Uncover the various challenges associated with each contracting element.
- PBM Discussion Questions: Learn which questions you should be asking your PBM during contracting discussions to build transparency.
The 7 terms in this eBook are:
- Rebates
- Formulary
- Specialty Drugs
- Prior Authorization
- Auto-Refill
- Employer Group Waiver Program (EGWP)
- Pharmacy Networks
Don’t let the complexities of PBM contracts hold you back from achieving optimal pharmacy benefits for your client or your organization. Use this guide to gain the knowledge, strategies, and confidence you need to take control of your healthcare expenses while delivering quality benefits to your employees.
Download Guide to PBM Contracts eBook
Make sure to check out Part 2 of this eBook series that takes a deep dive into Plan Sponsor considerations during the PBM contracting process.
