Why Work With a Pharmacy Consultant?
Pharmacy benefit comprises 20 to 25 percent of health care expenses, a significant component of total health care costs. Attributed in part to rising high-cost specialty medications and industry consolidation, these increases pose ongoing challenges for both organizations and plan participants across the nation.
With a robust specialty pipeline comprised of orphan drugs and gene therapies, predictions of higher year over year (YoY) spending will impact employers in the near future. Organizations need objective and reliable pharmacy-specific guidance in alignment with health care reform, industry trends and organization-specific key health plan initiatives.
Pharmacy Industry Trends
Industry estimates show prescription drug benefits will continue a steady rise
in year-over-year expense-to-health plan costs, with specialty costs equating
to 50% of overall pharmacy spend in the near future.
The CBIZ National Pharmacy Consulting Practice understands the need to
curb these prescription drug benefit costs and control health plan expenses. Our pharmacy consultants bring robust clinical and financial consulting expertise to clients as they
navigate the ever-changing pharmacy benefit landscape.
What Does a Pharmacy Consultant Do?
Our managed pharmacy consulting practice works with clients to review past pharmacy experiences and
provide strategic recommendations specific to an organization’s needs and
culture, while also providing guidance around best practices for pharmacy
management. In collaboration with local CBIZ consultants, the pharmacy team
provides client-specific pharmacy guidance, pertaining to health care reform,
industry trends and a client’s operating objectives. Our team also works
with pharmacy benefit managers (PBMs) to maximize the value of a client’s
pharmacy benefit spend by implementing the following strategies:
- Pharmacy Benefit Manager (PBM) contract review
- Carve-in & carve-out options
- Pharmacy Benefit Manager marketing (procurement)
- Plan design, benefit management & implementation oversight
- Market check
- Annual pharmacy experience review & clinical recommendations
- Vendor management & member issue resolution
As a top 25 broker of U.S. business, our team of robust clinical and financial consultants can help you navigate the ever-changing pharmacy benefit landscape. Applying best practices for managed pharmacy consulting, we will review past pharmacy experiences and provide strategic recommendations specific to your organizations’ needs and culture.
What Sets CBIZ Pharmacy Consulting Services Apart?
CBIZ distinguishes itself from competitive brokers in the marketplace by maintaining objectivity and does not own, operate, or have ties to a pharmacy benefit vendor. CBIZ does not operate our own PBM coalition. This allows for truly unbiased examination, assessment, and counsel of our clients’ pharmacy benefit management programs. By aligning solely with our clients’ objectives, vendors are assured fair and equal treatment, ensuring highly competitive financial offers.
Through collaboration, we will develop financial models, pharmacy program analyses and clinical evaluations designed to save our clients as much as 20 percent in annual pharmacy spend. These efforts are led by Michael Zucarelli, PharmD, a licensed and practicing pharmacist who serves as CBIZ's National Pharmacy Practice Leader. Additional team members offer our clients a breadth of pharmacy expertise ranging from marketplace perspectives to vendor capabilities, as well as valuable practical and clinical knowledge.
We Treat Each Client With Care
Our philosophy is simple: we will work hard to earn your trust and gain your confidence. We treat each client with the utmost care; we develop strong personal relationships; and we provide service with a commitment to professionalism and the highest level of personal and professional integrity. Working together, our pharmacy consultants can help you curb prescription benefit costs and build a high-value competitive benefit plan that leads to happier, healthier employees.