Pharmacy Benefit Management
How to gain from a smart Pharmacy Benefit Management (PBM) approach Print E-mail

PharmHealthTM brings the value of unique partnering relationships with participating Pharmacy Benefit Manager’s so that the PBM's truly become PBA's working exclusively on your behalf under clearly defined rules, exactly like your health plan TPA works.

  • Consult and assist in formulary design yet relinquish all control.
  • Guarantee you receive 100% of all fees received from the pharmaceutical companies to the plan sponsor (includes administration fee, access fee, fixed and volume adjusted rebate shares, script change fees).
  • Receive a fixed income in the form of an all inclusive pepm fee paid only from you.  No extra margins from minimum script fees, co-pays in excess of script costs, etc.
  • Have clear prescribed performance standards and penalties.
  • Are required to pay the pharmacies the exact same amount charged to the plan in every case (something still not happening today, even in "transparent" contracts).
  • Are not allowed to sell or otherwise share any of your information.
  • We review 100% of all claims processed monthly to quickly identify patterns of concern and take rapid action