Xevant Case Study: PBM Pricing Improvements
• Group with 200,000 lives and 3-year-old PBM contract • Using BidLogic compared multiple pricing offers including network and specialty variations
Employer group interested in retaining incumbent PBM but desired more favorable pricing and contractual terms based on basic knowledge of PBM landscape. Approached consultant to issue a costly RFP. Consultant sought price improvement from PBM in an attempt to retain incumbent which resulted in marginal but pricing adjustments.
Using BidLogic, consultant instantly compared multiple pricing offers from many PBMs including network, tiered formulary, and specialty variations. Consultant was also able apply increased utilization and inflation projections for a three-year savings model for the customer. Consultant used BidLogic presentation template to provided pricing conclusions and make PBM recommendations.
Armed with the savings available through BidLogic, consultant negotiated with the incumbent PBM and avoided the cost of a full RFP ($30K). Through improved pricing strategies, consultant saved the group 34.5% in annual plan costs (>$10M over 3 years). Further reduced costs expected through implementation of utilization management programs.