Implementation of best-in-class PBM contracting
The negotiation process starts with the bid. A well-managed procurement sets the expectation that the bidding PBMs will adhere to promises made during the contract’s bidding.
Engaging in a PBM competitive bid process allows clients to negotiate new terms and revise potentially outdated definitions. The RFP process presents the ideal opportunity to:
1. Clarify all fees
2. Apply drug-pricing benchmarks
3. Establish inflation protection
4. Enhance billing and termination clauses
5. Implement or revise operational performance guarantee
6. Ensure adequate audit and market check rights
You need the ability to adjust your contract as the market landscape changes. Flexibility in contract terms achieves this and demands a true partnership with a PBM vendor. For example, consider both business practices, pricing, and the PBM’s revenue sources when considering how much transparency exists within the PBM contract. Review our checklist of contracting questions.
Merely negotiating price points isn’t good enough. All contract methodologies should be examined and, at a minimum, be aligned with industry best practices, current market metrics, and unique business needs.
PSG has rewritten the rules for PBM vendor accountability. Our thorough and meticulous approach to contracting positions the client as the quarterback of the benefits program, empowered to make decisions for the good of the organization and its members.
Download the carefully curated list of nine essential contracting questions to achieve the best contract possible in the 2022 PSG Complete Playbook.