In today’s ever-changing and complex pharmaceutical market, there are many options to choose from when it comes to selecting a pharmacy benefit manager (PBM) to work with.

When choosing the right PBM for your organization, there is a lot of information to consider. That’s why today, we are breaking down the two most common misconceptions we hear from health plans and self-funded entities, regarding the size of a PBM.

2 Common Misconceptions About PBM Size

Misconception #1: Smaller PBMs Can’t Provide Competitive Rates Like Larger PBMs Can

We have seen, in our own data, smaller PBMs out-perform larger PBMs.

How?

To compete with larger PBMs, the smaller PBMs must aggressively negotiate contracts on behalf of their clients. These negotiations include passing through more savings onto their clients than keeping money as revenue. Along with diligent formulary management, sound clinical programs, and flexible and customizable plan designs, these types of PBMs offer a viable alternative solution that competes very well.

Misconception #2: Larger PBMs Won’t be Able to Provide the Level of Customer Service Smaller PBMs Can

When it comes to customer service in the PBM industry, it goes further than what most people traditionally think of as customer services. Large PBMs have the ability to provide services health plans and other organizations aren’t equipped to handle. These PBMs can act as an entire pharmacy department or take on aspects such as formulary benefit management, data management, or call center services. Delegating services to the PBM can be a cost-effective solution and promote better communication between employers and PBMs.

There are many benefits to both small and large pharmacy benefit managers. However, when it comes to choosing a PBM, it is essential to take into consideration your organization’s needs and expectations.

Need assistance to determine the best fit for your organization? Contact one of our experts at PillarRx!