What's an anti-PBM?
DISCOVER THE DIFFERENCE
How drugs are priced
Multiple price lists, designed to benefit the PBM. No visibility for the plan sponsor until 30 to 90 days after the claim is paid.
PBM
Rescription works with our partners to get the lowest available price on every drug at every pharmacy. Our guaranteed published prices are available to see before a claim is ever processed.
anti-PBM™
How you save
PBMs promise lofty savings goals by restricting members. Goals are met by deleting drugs from the formularies, delaying through PAs, & denying patients' access to prescription drugs.
PBM
Rescription achieves 20-40% plan savings from exclusive prices through our health system partners at point-of-sale.
anti-PBM™
How we make money
PBMs rely on various admin fees, drug manufacturer kickbacks, and owning their specialty or mail order pharmacies to generate their revenue. This means they make more money when you spend more money!
PBM
Rescription only has one source of revenue, a simple PMPM subscription. This flat subscription allows us to focus on one thing: Saving you and your members money.
anti-PBM™
Plan sponsors and consultants are rightly suspicious of PBMs, and an RFP is their only tool to suss out the games and gimmicks. This is why RFPs can often stretch to 500 or 1,000 questions as sponsors try to evaluate every possible way that the PBM will try to earn revenue and skirt obligations at their expense.
PBM
Rescription, consultants, and plan sponsors are all on the same side with nothing to hide, so there is no need for a cumbersome RFP process. A simple claims repricing and contract review is all that is necessary to understand the collaboration model.
anti-PBM™
PBM formularies are designed to maximize rebates, which means more money in their pockets from rebate spread and drug manufacturer "administration fees" that allow them to claim to pass through 100% of rebates while still getting paid by the manufacturer. This means limited drug access at higher costs for members.
PBM
Formulary is designed to be open, keeping drug choice decisions in the hands of patients and their doctors. Pricing is optimized to get the lowest possible net price and to get it up front, cutting out the need for formulary games.
anti-PBM™
GLP-1s like Ozempic and Wegovy are restricted, either not covered at all or locked behind PA processes with 50%+ denial rates. Plan sponsors are forced to be the "bad guys" denying patients access to popular, life-changing drugs.
PBM
By leveraging exclusive hospital system collaborations, GLP-1 pricing is reduced by over 60%, with a $0 copay for members through the Saver Program.
anti-PBM™
When PBMs delay and deny access to patients' drugs, their HR Benefits team is the first to get the call. HR Benefits ends up being the "bad guy" left to explain the policies to unhappy members.
PBM
Patients are able to access the medications that their doctors prescribed, at lower costs, without the barriers put up by PBMs. When members are happy, the phones in HR Benefits don't ring.
anti-PBM™