PillarRx works with a health plan that has several lines of business including commercial and Medicare Part D. The client wanted to identify in the market if there were opportunities to save additional money in the specialty space as well as understand the operational capabilities and standards within the specialty fulfillment process. The client was anticipating significant growth for the new year and sought to ensure they had the right specialty solution in place operationally to support the new membership as well as to optimize pricing for product discounts, rebates, and other manufacturer monies available.
The PillarRx team provided support through a focused RFI effort that included creating specific questions to inquire about a comprehensive financial analysis for specialty drug solutions. Five potential bidders were solicited to respond to the RFP. After PillarRx received the bidder responses, the team completed their review/scoring of the questionnaire responses and a full comparative analysis of the financials. The project was completed on time and a summary of the evaluation was presented to the client.
Ultimately, the client decided to stay with their current vendor supporting specialty services. PillarRx was able to assist the client in improving their specialty product discounts and manufacturer rebates. We also provided guidance and support with revising the current specialty services language in the contract including new definitions, revised caveat language, removal of language that was not in the best interest of the client, improved pricing language, and added clarity and details to operational expectations and deliverables.