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Rebates, Spread Pricing, and Hidden Fees: What to Ask Your PBM Today

Rebates, Spread Pricing, and Hidden Fees: What to Ask Your PBM Today

by betvmsibg | Aug 28, 2025 | Data Analytics, Drug Costs, Health Plan Costs, Health Plan Design, Pharmacy Benefit Managers (PBMs), Public Sector Benefits

When it comes to managing pharmacy costs, one of the most complex areas for employers is understanding how their Pharmacy Benefit Manager (PBM) structures contracts and fees. PBMs play an essential role in administering prescription drug programs, but the lack of...
Carving Out Pharmacy Benefits: When It Makes Sense, When It Doesn’t.

Carving Out Pharmacy Benefits: When It Makes Sense, When It Doesn’t.

by betvmsibg | Jun 26, 2025 | Drug Costs, Health Plan Costs, Health Plan Design, Pharmacy Benefit Managers (PBMs), Public Sector Benefits

As pharmacy costs continue to be one of the fastest-growing components of healthcare spend, employers are increasingly evaluating whether carving out pharmacy benefits from their medical plan makes strategic and financial sense. While the decision can offer greater...
GLP-1s, Gene Therapies and the New Frontier in Drug Costs: Navigating 2025 Renewal Pricing and Formulary Management

GLP-1s, Gene Therapies and the New Frontier in Drug Costs: Navigating 2025 Renewal Pricing and Formulary Management

by betvmsibg | Jun 12, 2025 | Drug Costs, Health Plan Costs, Health Plan Design, Pharmacy Benefit Managers (PBMs)

Groundbreaking therapies such as GLP-1 receptor agonists and advanced gene therapies have dramatically reshaped the cost structures for employee benefit plans. As organizations gear up for their 2026 benefit renewals, understanding these developments is crucial for...
Breaking Down Barriers: How Transparent PBM Practices Drive Better Benefits

Breaking Down Barriers: How Transparent PBM Practices Drive Better Benefits

by betvmsibg | Jan 27, 2025 | Health Plan Costs, Health Plan Design, Pharmacy Benefit Managers (PBMs)

The challenges surrounding Pharmacy Benefit Managers (PBMs) have long been a topic of concern for employers, healthcare professionals, and policy advocates. Recently, entrepreneur Mark Cuban reignited the conversation with his pointed critique of PBM practices, as...
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