It sounds like a simple goal to “reduce pharmacy drug spend,” but if you find yourself wondering where to start or even if you are partially down the path and lost, what do you do?
Let us help you. PillarRx’s process begins with you, the client! We focus on helping clients solve a problem, meet a need, and/or achieve a goal with solutions tailored to meet the unique needs of each PillarRx client.
Shopping for a new Pharmaceutical Benefit Manager (PBM) can feel like shopping for the perfect car. You’re excited about that new car smell but finding the right fuel economy, body style, payment, and even brand is important to you. If you have a family of five, a sporty two-door coup isn’t the right fit, even if it’s a “great price.” Wouldn’t it be terrific to have someone who understands the auto industry to ask the right questions to help you understand what you need and want, then present you with the best options? While we may not be able to help find that perfect car, we can help cut the confusion out of PBM shopping!
So, what is a good process for PBM shopping? Well, we believe it contains the five core steps outlined below.
Step 1 – Project Kick-off and Needs Assessment
PillarRx’s Project Kick-off and Needs Assessment is a critical project phase. We believe a successful RFP outcome begins with open communication and sharing thoughts and ideas about what you are seeking in a PBM partner. Your PillarRx Team will guide you through this information-gathering phase of the project and discuss the steps of the full RFP process and what can be expected as part of the overall project tasks and deliverables. This phase ensures the RFP accomplishes what you are pursuing and fulfills any goals that you would like to meet.
Step 2 – RFP Package Creation
The next step includes creating the RFP Package that will be delivered to the PBMs/PBAs for a response. The custom RFP package is created using information gathered in the Project Kick-off and Needs Assessment phase to ensure your goals are met. PillarRx will draft all documents to support the RFP and provide them to your team for review and approval.
Step 3 – RFP Package Delivery
Now we are ready to deliver the RFP package to the PBMs/PBAs to solicit a response from select potential partners. PillarRx will provide all requirements to bidders and manage the collection and assembly of replies while keeping everyone accountable to the timeline.
Step 4 – RFP Response Evaluation
PillarRx reviews the proposals using proprietary analytical software, which has similar sophistication and functionality as a PBM claims processing system, and a team with extensive industry knowledge. The right subject matter experts review the PBM’s RFP responses and provide meaningful but easy-to-understand evaluations. The results are shared in a comprehensive format that includes the scoring and professional opinion for each main component of the RFP response. The insight provided in the overall summary results assists you with making an informed decision about who are the top contenders and deciding upon the next steps for the evaluation process.
Step 5 – Finalist Interviews & PBM Partner Selection
PillarRx will guide the PBM interview process as well as manage meeting coordination, capturing, and addressing follow-up items, and ultimately allowing you time and the focus to get to know each bidder. PillarRx will provide expert opinion and guidance on what we have seen throughout the process and provide facts as well as expert recommendations to assist you in making the right choice for best managing your pharmacy benefits program.
If you are interested in learning more about how we can help you, please reach out to us at [email protected]. We welcome your questions and are here should you need pharmacy expert assistance.