What is a Pharmacy Benefit Manager?
A Pharmacy Benefit Manager (PBM) serves as an intermediary between the insurance company or third party administrator and the pharmacies. PBMs are the only subset of healthcare that remains unregulated. They determine pharmacies in the plan’s network, develop the formulary, and negotiate price rebates with drug manufacturers. Manufacturers provide rebates in exchange for having specific medications listed on the formulary.
What’s a Fiduciary PBM?
100% clinical intervention with patient & prescriber
Does not rebate, spread price, or repackage drugs
Does not sell patient information
Only allows new prescriptions on formulary when independently confirmed safe and effective
Uses independently contracted mail order passing through acquisition cost
No public stockholders
All Revenue Disclosed
Traditional PBM versus Our Fiduciary PBM
Traditional Spread Pricing
Typically, PBMs generate undisclosed revenue by marking up the cost of generic prescriptions, pocketing the difference between what the PBM actually pays and the amount the PBM invoices the client.
Our Fiduciary PBM
On every prescription filled, our Fiduciary PBM utilizes the lowest contracted rates to the employer plan. The only revenue for a Fiduciary PBM is the fully disclosed administration fee.
Learn How VHA Can Move Your Business Forward
Talk With One of Our Healthcare Specialists Today