AREAS OF EXCELLENCEPharmacy & PBM Analysis

Our team of account executives and our in-house licensed pharmacist have success identifying hidden revenue streams that save our clients millions of dollars.

LHD has made significant investments to obtain an in-depth understanding of pharmacy costs and prescription benefit managers (PBMs). Our experience in PBM contracts has uncovered numerous hidden revenue streams and yielded multiple millions of dollars in savings for our clients. Our strategy includes:

  • Analyze Existing Rx Plan: We review existing Rx plans then design strategies to manage specialty drugs differently (carve outs, Rx help centers, etc.)
  • RFP Process: We conduct a comprehensive RFP process to identify hidden revenue streams, encourage
    transparency, and lower employer/employee cost.
  • Contract Analysis: We educate employers about the complexities of PBM contracts and carefully
    analyze the details to protect your interests.
  • Monitor Rx Plan Performance: We closely monitor the Rx plan performance using cost analysis and
    trend data to report results and recommend corrective action.
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OUR APPROACH

Client Success Story

As a mid-sized local company, the savings LHD identified was literally business-saving. They earned a client for life.

A client with a cost per employee substantially above local and industry benchmarks needed to have plan design and provider flexibility due to a collective bargaining agreement.

Solution: We carved out their PBM from the insurance company and negotiated a direct PBM contract. This
direct contract improved Rx pricing for retail and home delivery purchases and significantly increased
pharmacy rebates, reducing overall Rx costs without any noticeable disruptions to the members.

Results: Combination of reduced costs and increased rebates saved the client more than $250,000 over the
3-year contract.

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