The status quo of the PBM market comes with mis-aligned incentives. Drug pricing is so complex that even the savviest of plan sponsors may not know all of the charges buried in their contracts.
Today’s big PBMs line their pockets through opaque pricing tactics known as “spread pricing.” Spread pricing is the practice of reimbursing the pharmacy one amount for a medication, charging the plan sponsor a higher price for the same drug, and pocketing the difference.
Often, plan sponsors don’t know exactly how much more they are being billed for a drug than the pharmacy was reimbursed for it. They don’t know this because of the complexity of pharmacy pricing and the lack of appropriate transparency.
That’s where we come in. With Labor Value Rx, you as Fiduciaries or Consultants know who is being billed what and are able to determine if those costs are reasonable.
For a more in-depth look at why the need for transparency in Pharmacy is greater than ever, follow the link below: