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Prescription Drug Benefits Services
Evolution Benefits Consulting has a proven, effective approach for procuring best-in-class PBM arrangements for our employer clients.
Our Approach
We begin asking our clients what they want as a result and to rank these areas of examination:
- Financial Metrics
- Clinical Services
- Customer Service
- Communication Support
- Mail Order Performance
- Administrative
- Network Access
- Implementation Support
- Performance Guarantees
- Formulary Disruption
We will create a request for proposal categorized in these areas with appropriate weightings that are developed based on client feedback.
The procurement process, unique to Evolution, compels each of the bidding vendors to meet a number of “minimum requirements” before being allowed into the process. We create a hurdle by dictating aggressive financial terms, guarantees and contract terms each vendor needs to meet before they proceed. We have found that PBM contracts are often intentionally written in ambiguous terms that may allow certain provisions to appear more generous than they are in actuality. Our industry knowledge allows us to demand terms and guarantees that are easy to:
- Compare amongst responding vendors
- Quantify into client value
- Audit on an on-going basis
Client Value
Depending on your current state, this approach can yield 5% to 15% savings, without cost shifting. Savings result from tighter contract terms and more aggressive financial metrics/guarantees. For a client with 5, 000 employees spending $1,400 per employee, savings could reach $700,000 or more.