Unlocking Savings and Growth Opportunities in the PBM Landscape.
Client Situation
Rebates – essential discounts from drug manufacturers – serve as vital cost-saving mechanisms, enabling PBMs to maintain competitive pricing for their customers. Drug innovation, shifting legislation, and changing patient behavior can render old arrangements outdated, costing organizations considerably in their wake.
A PBM had outsourced its rebate management but found themselves dissatisfied. They suspected they were missing out on potential savings and wanted to improve their financial situation. They needed assistance in navigating the marketplace and finding a better partnership.
Opportunities/Actionable Items
The Proper team got down to business. They audited the PBM’s current rebate contract and discovered it wasn’t performing as it should. The PBM wasn’t getting the guarantees they were owed and the pricing they were receiving was lower than the market commanded.
To remedy the situation, Proper proposed a solution: the PBM should open the floor to bidding for the rebate management job. This way, they could compare offers and choose the best option. After receiving bids from various vendors, the Proper team analyzed each one thoroughly, weighing the financial benefits and potential risks.
Eventually, they found a vendor offering a lucrative deal. Helping the PBM negotiate a contract with this vendor, Proper ensured it aligned with the PBM’s requirements. They also developed a suite of dashboards to support the PBM in tracking the new arrangement effectively.
Results
The results were remarkable. With a restructured rebate contract, the PBM secured an increase of over 30% in rebates. This not only allowed them to honor their commitments to customers but also facilitated business growth. Armed with advanced monitoring tools, the PBM could make informed decisions and pursue strategic initiatives confidently, emerging stronger and better positioned within the industry.