Benchmarking is a process of continuously measuring an organization’s products, services, and practices against a recognized leader in the studied area for the purpose of improving business performance.

From a health care perspective, utilizing benchmarking pharmacy data is important because a Pharmacy Benefit Manager (PBM) could be exceeding contractual performance language and/or monetary guarantees, but if the contract isn’t meeting or following independent third-party pharmacy sources, the contract or PBM may not be as good as it seems.

Third-Party Benchmarking is a key step to the audit process PillarRx takes to compare PBM claim files, claim re-adjudication output, and independent pharmacy data sources. This triangulation process allows PillarRx to identify PBM rates that may not be in line with the pricing we typically see in the marketplace. These third-party sources include:

  • First Data Bank – Validates brand and generic algorithms
  • Medi-Span® – Validates Average Wholesale Price (AWP)
  • National Council for Prescription Drug Programs (NCPDP) – Validates pharmacy type

What are the Benefits of Benchmarking?

  • Competitive Analysis – By identifying areas of opportunity through market benchmarking; it can help you to know where you can possibly enhance your PBM contract, a clinical program, and/or outcomes of a specific initiative.
  • Monitor Performance – Benchmarking involves looking at retrospective and current trends in data to better understand where you have been and to better predict what could happen in the future. This in essence assists a client with how to better prepare for what may be ahead.
  • Continuous Enhanced Knowledge – As well as Monitor Performance, Continuous Enhanced Knowledge can be gained through ongoing benchmarking efforts. This should not merely be something that improves once and is forgotten, but something that improves over time and is constantly being evaluated and refined, which in turn can assist with understanding how to best look at how the program is performing
  • Planning and Goal Setting – Once opportunities are identified using benchmarking, goals and performance metrics can be set to improve performance.

If you are looking for a full-service pharmacy consulting company that specializes in data analysis and benchmarking services, reach out to PillarRx at [email protected].