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Health Systems and the Fiduciary PBM: Why Control of Your Pharmacy Benefits Matters

Traditional PBMs often compete with the health systems they serve. Why health systems should control their formulary, and what a fiduciary PBM offers instead.

By Ken Kemker • April 7, 2025 • 4 min read

Health Systems and the Fiduciary PBM: Why Control of Your Pharmacy Benefits Matters

Health systems face increasing pressure to manage costs while maintaining quality care. One area deserving critical examination is your pharmacy benefits management (PBM) relationship. As healthcare entities with a mission to serve communities, health systems must ask: Are your current PBM arrangements truly serving your organization’s best interests?

The Uncomfortable Truth About Traditional PBM Relationships

Health systems and health plans nationwide are discovering a troubling reality: many traditional PBMs operate with inherent conflicts of interest. While managing your pharmacy benefits, these same entities are simultaneously building competing healthcare facilities that directly challenge your own service offerings.

Consider this scenario: Your organization partners with a major PBM to manage pharmacy benefits, only to watch that same company open competing emergency rooms and physician practices in your service area. This competitive dynamic raises serious questions about whose interests are truly being prioritized.

The Critical Question: Who Controls Your Formulary?

For health systems, pharmacy management represents both a significant expense and a crucial component of patient care. Yet many organizations have surrendered control of their formularies to PBMs that prioritize their own financial interests over clinical outcomes and patient needs.

When you lack control over your formulary decisions, you’re effectively outsourcing a key strategic function of your organization. This arrangement can lead to:

  • Misalignment between formulary decisions and your clinical priorities
  • Reduced flexibility to adapt to your specific patient population needs
  • Limited visibility into the true costs behind pharmaceutical spending
  • Inability to fully integrate pharmacy services with your care model

The DisclosedRx Difference: A Fiduciary Approach

As The Fully Disclosed PBM®, DisclosedRx operates with a fundamentally different philosophy. We function as a fiduciary PBM, contractually bound to act in your best interests—not our own.

Our approach centers on several key principles:

  • Full transparency: 100% pass-through of all rebates and pricing
  • Single, straightforward admin fee: No hidden revenue sources or shell games
  • Custom formulary design: Built around your specific clinical and financial goals
  • Member-centered service: Dedicated support for your employees and their families

Regaining Control of Your Pharmacy Strategy

Health systems deserve a PBM partner that begins by understanding your unique needs and goals. Rather than forcing you into standardized programs, we build custom solutions designed specifically for your organization.

Our collaborative process includes:

  1. Assessing your current pharmacy management challenges
  2. Understanding your strategic priorities and clinical focus areas
  3. Designing a custom formulary aligned with your care models
  4. Implementing enhanced specialty cost control programs where needed
  5. Providing complete visibility into all financial aspects of your pharmacy benefit

Beyond Cost Savings: Honoring Your Mission of Service

Health systems exist to serve communities in need—not to enrich pharmacy middlemen. DisclosedRx recognizes the selfless nature of healthcare work and designs pharmacy benefit solutions that honor this service mission.

When we put your interests first, financial benefits naturally follow. Our structure ensures savings flow to where they belong: your organization and your members.

Real Results: Better Experience, Lower Costs

The DisclosedRx approach delivers dual benefits that traditional PBMs cannot match:

  • Enhanced member experience: Reduced wait times, simplified access, and personalized support
  • Meaningful cost reduction: Through elimination of hidden fees and optimized medication channels
  • Specialty medication savings: Programs delivering up to 75% savings on specialty medications
  • Zero-dollar copays: Making medications more accessible for your members

A Partnership Built on Trust

The relationship between a health system and its PBM should be based on trust, alignment, and shared goals. DisclosedRx provides the assurance that we’ll consistently do what’s right for your organization and members.

By choosing a fiduciary PBM, you’re not just changing vendors—you’re fundamentally transforming how pharmacy benefits support your overall mission and financial health.

Are You Ready to Fulfill Your Fiduciary Responsibility?

Health systems have a fiduciary duty to ensure all partnerships serve their organizational mission. As competing facilities owned by traditional PBMs continue expanding into your markets, the question becomes increasingly urgent: Is your current PBM arrangement serving or undermining your strategic interests?

DisclosedRx offers a better way forward—one built on Full Disclosure, contractual accountability, and genuine partnership. When you’re ready to regain control of your pharmacy benefits strategy, we’re ready to show you how.

DisclosedRx operates as The Fully Disclosed PBM®, providing health systems with complete visibility into pharmacy benefit costs while aligning with their clinical and financial goals.

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