Pharmacy Consulting

Pharmacy Consulting and Contract Reviews

For many companies, prescription drug spending accounts for between 25% and 30% of their healthcare costs. Our pharmacy consulting practice can deconstruct your prescription program. We’ll create greater transparency and more advantageous contracts, immediately reducing costs. Best of all, there is no change to benefit or plan design.

What Is Pharmacy Consulting?

Pharmacy benefit consulting is a specialized service that provides expert advice and guidance to organizations on managing their pharmacy benefits programs. Pharmacy benefits are a significant component of an organization’s overall employee benefits package, and pharmacy benefit consulting helps organizations maximize the value of their pharmacy benefits while minimizing costs.

Pharmacy consulting services typically involve a comprehensive review of an organization’s pharmacy benefits program, including the plan design, prescription drug formulary, pricing and utilization management strategies. The pharmacy benefit consultant works with the organization to assess its pharmacy benefits needs and goals and develops a customized pharmacy benefits program that meets those needs and goals.

What We Do for Your Organization

Exude can help reduce the cost of unnecessarily expensive employee benefits through pharmacy consulting services. Our Certified Pharmacy Benefit Specialists (CPBS) have received in-depth training in pharmacy benefits. We understand prescription drug benefits and the most effective strategies for saving you money. Often, organizations can save 30% or more on their prescription drug spending costs with help from our team.

Here are some of the key functions our pharmacy benefit consultants provide.

Assess Pharmacy Benefit Needs

Our pharmacy consulting services help organizations assess their pharmacy benefit needs and goals. This process may include reviewing how employees use your plan and analyzing prescription drug claims. We can also evaluate employee feedback on their current pharmacy benefits program, such as whether they feel it meets their needs.

Develop a Customized Pharmacy Benefits Program

Based on the needs assessment, the pharmacy benefit consultant develops a customized pharmacy benefits program that meets your goals and budget while increasing employee satisfaction. The program may include strategies such as:

• Formulary management: This service involves instituting systems to select cost-effective, high-quality prescription medications.
• Utilization management: With this approach, you can ensure employees receive the right medications at the right time for the right duration.
• Prescription drug pricing:  We analyze and understand the complex costs influencing drug prices and work within benefits programs to get the best prices.

Implement the Pharmacy Benefits Program

Our consultant will assist you in implementing the new pharmacy benefits program. This process may include working with your human resources (HR) team to communicate the changes to employees, setting up new contracts with pharmacy benefit managers (PBMs) and training employees on how to use the new benefits program.

Monitoring Pharmacy Benefit Program Performance

Once the new pharmacy benefits program is implemented, we will monitor its performance to ensure that it is meeting your goals. This monitoring may involve analyzing utilization data to determine employee health risks and treatments. We can also review prescription drug claims and provide recommendations for adjustments or improvements.

Following Pharmacy Benefit Trends and Regulations

Our pharmacy benefit consultants stay up to date on changes in regulations and trends in pharmacy benefits. This knowledge of pharmacy market dimensions and pricing benchmarks allows them to provide you with expert advice on how to manage pharmacy benefits programs to ensure compliance with regulatory requirements and take advantage of the latest trends in the industry.

The Benefits of Pharmacy Consulting

There are several potential benefits to carving out your prescription drug benefit. Here are a few of the most significant advantages.

1. Cost Savings: One of the most significant benefits of carving out your prescription drug benefit is cost savings. PBMs negotiate directly with drug manufacturers and pharmacies on behalf of the organization to obtain the best prices for prescription drugs. Because PBMs work with multiple clients, they can leverage their buying power to negotiate better prices and discounts than an individual organization could obtain on its own. As a result, you could earn extensive yearly savings and reinvest funds in other areas of your business or employee wellness.
2. Increased Transparency: By separating your pharmacy benefits program from your comprehensive benefits plan, you gain more transparency into the costs and pricing of your prescription drugs. We’ll develop detailed drug cost and discount reports, allowing you to better understand the cost drivers of your pharmacy benefits program.
3. Flexibility: Carving out your prescription drug benefit provides more flexibility in plan design. Instead of being tied to the benefits and plan design of a comprehensive benefits plan, you can tailor your pharmacy benefits program to your organization and employees.
4. Expertise: PBMs can provide guidance and advice related to your prescription drug program. We can tell you which prescription medications are covered by a health plan and offer guidance on how to ensure employees use medications more effectively.
5. Improved Member Experience: PBMs provide tools and resources to help members manage their prescription drug benefits. These tools can include mobile apps, virtual communication and customer service support. With better tools and resources, you gain an improved member experience and increased satisfaction with the pharmacy benefits program.

An Expert Pharmacy Consulting Company

Exude is an excellent choice for managing your prescription drug benefits. Our company is one of only 600 Certified Pharmacy Benefit Specialists in the country, meaning we have the critical knowledge necessary for effective management. Besides pharmacy consulting, we provide expertise across all areas of employee benefits, from Medicare to retirement. We can even help your organization build an effective employee well-being program to support physical and mental health among your staff.

Our team has been helping companies with their employee benefits since 1996. Our mission is to change lives for people who are changing the world. To achieve this goal, we offer 24/7, highly responsive service, giving you the personalized care you need. We care for you and your employees so you can focus on impactful work.

Contact Us for Pharmacy Benefit Management Consulting

Carving out your prescription drug benefit from your employee benefits package can provide several benefits, including cost savings, increased transparency, flexibility, expertise and improved member experience. Before making any changes to your pharmacy benefits program, it’s essential to work with a trusted advisor, such as a benefits consultant or PBM, to assess your needs and goals and develop a customized plan that meets your organization’s needs. If you need support, contact our team online.