Real-Time PBM “Pricing” From Prescription Solutions

I don’t do a whole lot in the PBM pricing world these days, but I remember some of the process and the underwriting steps.  That being said, I was really impressed with the new Prescription Solutions online Pharmacy Benefit Advisor Tool (go to 

You go through a few basic steps to get an idea of how much you (payer) could save (with a very nice GUI). 

  1. Rank the features that matter to you – net cost, compliance, shifting cost to the consumer
  2. Rank the importance of different clinical programs
  3. Make some trade-offs in programs (A is more important than B)
  4. Enter some baseline data

Now, in reality, PBM pricing is never that simple, but what it effectively does is help articulate the savings that different decisions can create in a real-time setting.  It also forces some dialogue around issues – adhererence versus drug cost…which matters more to you?

I also think it could be a great way to help consumers understand the costs and savings associated with certain decisions.  I would also guess that the sales team at Prescription Solutions will find it helpful especially in the smaller, self-funded world.

One Response to “Real-Time PBM “Pricing” From Prescription Solutions”

  1. This is great. It’s a nice improvement over what they announced a few months ago.

    With this, and their repositioning of the business under Optum brand umbrella, I guess the chance of UHG selling or spinning off its PBM arm is looking less and less likely.

    Thanks for sharing.

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