The tide is turning in the PBM world! I’m here for it. In just the last few months here’s a snapshot of what’s transpired:

1.     J&J Faces Lawsuit – Alleged breach of fiduciary duty by company and its benefits team related to PBM deal with ESI arranged by Aon. A major eye opener for any employer still in a classic, rebate-driven PBM model. [Note: Our client work was referenced within the filing as an example of what a prudent plan manager would do.] Read more…

2.     Tyson Foods Makes a Switch – Poultry powerhouse moves their 150,000 plan members from CVS to relative upstart PBM RightwayRx. Read more…

3.     Mark Cuban Speaks – Noted “shark” and Cost Plus Drug founder makes bold statement that, “If you’re with one of the big three, you’re getting ripped off.” Read more…

4.     Broker/PBM Arrangements Exposed – STAT News releases an exposé shining a light on hidden fees and compensation many brokers, consultants, and coalitions have negotiated with PBMs. Read more…

5.     Pay-to-Play Schemes Revealed – While being interviewed on the Relentless Health Value Podcast, CapitalRx CEO AJ Loiacono makes a firsthand revelation of some outrageous “pay-to-play” fee requests made by brokers and consulting firms during the RFP process. Read more…

Thankfully, it appears self-funded employers are finally starting to see the light.

While most have long taken comfort in the illusion of fiduciary responsibility projected by the Big 3 PBMs, purchasing groups, and large brokers/consulting firms, new transparency and disclosure rules might be causing you to rethink that perspective.

At the same time, a number of progressive employers, alternative PBMs, and independent advisors have embraced the fiduciary mindset and set a new standard for transparent arrangements resulting in major savings.

Considering we’ve been at the forefront of this movement for the last 10 years, we have the experience and proven process in place to reduce plan sponsor risk and optimize their results. Please let us know if you’re ready to embrace a better way.

P.S. For those of you whose first instinct is to initiate change by approaching your current broker/consultant/PBM for help, we suggest you reconsider and ponder what/who brought you to this point in the first place!