Our hands-on Pharmacy Benefit Consulting services provide the heavy lifting so that you can stay out of the full-time PBM watchdog role and focus on what you do best while we drive down the cost of pharmacy.

If your contract is over 2 years old you are leaving a minimum of 20% in savings on the table. Negotiation does not mean you have to remove your PBM.

PBM’s will not sign a fiduciary statement. They do not function in your best interest and can take advantage of a complicated industry. Unbiased expertise help align your interests with the PBM.

Considering that most contracts are over 40 pages long, you need a subject matter expert to review your contract for details that could cost you money without any adjustments to your program.

Remember: In many cases, cost savings are not the sole objective for PBM programs. Most PBM programs are developed to drive rebates and/or increase fees.

Forward planning is an important part of being prepared for the next steps in PBM management. You or your PBM consultant should have a plan to combat the elimination of rebates.

PBM lawyers use complicated language or subtle references that eliminate or reduce your plan savings. Each PBM lawyer is trained in the minutia, if you don’t have a subject matter expert you are leaving savings behind.

Transparent or Pass Through, POS Rebates and Administrative Credits are all part of the complicated PBM pricing model. Although PBM’s will tell you that they have a simple model, there are over 40 ways to price a single claim. We know how to manage PBM pricing models.

It's not uncommon to see a fluctuation in contract variance, underperformance leads to a substantial cost increase to the plan. HLX performs yearly Financial Audits on every group managed, resulting in millions of dollars returned to the plan.