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Navigating Pharmacy Benefits for The Modern Workforce
As a senior leader in Human Resources and benefits, you face the constant challenge of managing rising healthcare costs without sacrificing the quality of care for your employees. The escalating price of prescription drugs, driven by new specialty medications and complex supply chains, directly impacts your budget and strategic goals. You need a clear path to control pharmacy spend while maintaining confidence that your health plan remains a competitive advantage in attracting and retaining top talent. We understand the pressure to deliver value to both your organization and your people.
Strategic Pharmacy Benefit Consulting and Analysis
Brown & Brown provides sophisticated analysis and management for organizations navigating the complexities of pharmacy benefits. We work with HR, CHRO, Total Rewards, and Benefits & Compensation executives who are responsible for multimillion-dollar health plans. You are tasked with balancing fiscal responsibility and providing comprehensive, high-quality benefits. The ever-changing landscape of regulations, pharmaceutical innovations, and Pharmacy Benefit Manager (PBM) contracts makes this a formidable undertaking. We can help you find clarity and control in this critical area of your total rewards package.
Solutions to Optimize Your Pharmacy Benefits Program
We recognize that the growth in prescription drug spend is a primary driver of your overall healthcare costs. Your objectives likely include understanding the components of your pharmacy trend, managing specialty costs, and identifying high-inflation products with effective alternatives. Brown & Brown offers a suite of services designed to help you achieve these goals with minimal disruption to your members.
Our Services Include:
- PBM Procurement and Negotiation:
We guide you through the vendor selection process with an unbiased and independent approach. Our support includes RFP distribution, scoring, recommendations, and assistance with contract negotiations to secure favorable terms and implementation. We also handle renewal negotiations to maintain competitive pricing. - Contract Analysis:
The language within a PBM agreement can significantly affect its value. We review agreements to identify strengths and weaknesses, highlighting areas that can impact your bottom line. - Market Checks:
PBM agreements often span multiple years. We can stipulate and conduct frequent market checks to ensure your pricing remains competitive throughout the contract term. - Benefit Design Assessment and Modeling:
We assess your current benefit design and provide recommendations aligned with your overall health benefit objectives. Using proprietary algorithms, we model potential design modifications and present the outcomes in a straightforward manner for informed decision-making.
- Vendor Management:
We can assist in managing the PBM relationship on your behalf to ensure optimal plan performance and a satisfactory experience for your members. - Cost Containment Strategies:
Our specialists offer strategies that can substantially impact drug spend. These include:
- Carve-Out vs. Carve-in PBM Efficacy Analysis
- Custom Formulary Development
- Specialty Copay Assistance Program Review
- Specialty Pharmacy Coverage Alignment, Integrated Site of Care, and Medical Benefit Management Analysis
- Access to Rx Buying Coalitions and Cooperatives
- Audits and Assessments:
We help confirm contract compliance and claims adjudication accuracy through detailed pharmacy claims, rebate, and operational audits, as well as perform clinical and fiduciary audits. Our team also assesses clinical program offerings from PBMs and medical carriers, providing tailored recommendations for your plan and assessing return on investment.
Additional Resources
Market Trends
Our 2026 report unites Brown & Brown and Risk Strategies resources, knowledge and proven experience to deliver stronger insurance solutions for commercial insurance, employee benefits and personal insurance.
Shaping Transparency in Today’s and Tomorrow’s Pharmacy Benefits Marketplace
True transparency in the pharmacy benefit marketplace is more than publishing numbers or simplifying reports. It requires clear contractual, financial, and clinical accountability so plan sponsors can understand what drives their costs and what ...
The Cost of Ignoring Sleep: Improving Benefits Strategies for Better Outcomes
As is often said: sleep isn’t a luxury. It is a physiological necessity.
Transforming Specialty Pharmacy: A Holistic Approach to Better Outcomes
Specialty pharmacy is undergoing transformative changes, driven by the recognition of the need for a holistic approach to patient care, complexities of new treatments, advancing technologies, and evolving healthcare policies. Amidst these ...Explore Other Brown & Brown Consulting Solutions & Services
Connect with Brown & Brown
Pharmacy benefit performance directly affects both your benefits strategy and your budget. Brown & Brown’s consulting team partners with HR leaders to evaluate PBM performance, optimize contract structures, and ensure cost transparency across your pharmacy program. We provide actionable recommendations backed by analytics and clinical insights to help your organization balance value, compliance, and care quality.
