When a university health plan with 1,400 members approached us through their broker relationship, they were experiencing significant challenges with their pharmacy benefits program. What they discovered through our analysis not only shocked them but also provided a clear path toward substantial savings and improved member care.
The Challenge: Hidden Costs Impacting Plan and Members
The university’s broker recognized potential inefficiencies in their pharmacy benefits management and brought in DisclosedRx to conduct a comprehensive analysis which revealed over $450,000 in spread pricing within their current arrangement. This meant their existing PBM was significantly inflating medication costs, forcing both the plan and its members to pay substantially more than necessary for prescriptions. The markup was simply becoming profit for their PBM.
In total, the university had overspent nearly $700,000 in just one year.
When we presented our findings to the university’s benefits team, there was a pivotal moment of clarity. The university had assumed their previous arrangement was designed to maximize value. Instead, they discovered their pharmacy benefit spending was supporting an opaque model where:
- Drug costs were marked up without their knowledge
- Rebates weren’t fully passed through to offset plan costs
- Multiple revenue streams were hidden within complex contract language
The Solution: A Fiduciary Approach
As The Fully Disclosed PBM®, DisclosedRx operates differently. Our fiduciary model means we’re contractually bound to act in our clients’ best interests. For the university, this translates to several concrete benefits:
- 100% Fully Disclosed pricing with no markup on medications
- 100% pass-through of all rebates directly to the plan
- One clear administrative fee with no hidden revenue sources
- Enhanced specialty cost control programs that reduce both plan and member expenses
More Than Savings: A Partnership Built on Values
The university’s leadership particularly valued our commitment to honesty and exceptional member care. Our round-the-clock Member Service team will ensure that every concern is addressed thoroughly during the implementation process and beyond.
By shifting to our fiduciary model where we contractually work for our clients and no one else, the university is able to redirect their pharmacy benefit dollars back where they belong—into their educational mission and their people.
Your Organization’s Opportunity
If you’re concerned about the true cost of your pharmacy benefits program, reach out to us for a free analysis. We can help identify potential overcharges and inefficiencies in your current arrangement. The savings—as demonstrated by this university’s experience—can be substantial.
DisclosedRx believes you deserve to know exactly what your drug costs are, with no shell games, ever.
That’s our passionate promise as The Fully Disclosed PBM®.