Vendor contracting for PBM services: How to get more than you paid for

Abstract

With pharmacy costs continuing to rise up to 30% yearly, employers are more closely examining the way in which the prescription benefit is managed. As a result of pharmacy benefit management (PBM) industry expansion, drug pricing and services have improved in the last 3 to 5 years. The foundation of a PBM contract is built during the request for proposal process. Rather than asking the vendor 40 pages of questions, the RFP should tell prospective vendors about the employer's human resource strategy and how the pharmacy program fits into that strategy. The PBM contract should include a list of services covered in the base administration fee and a list of add-on services and costs.