ROI Calculator Methodology

The ROI calculator leverages a dataset of more than 1 million historical claims from 30+ groups powered by 15+ different PBMs. For each group we compare the results of how much a claim would have cost in terms of AWP discount had the group used the SmithRx network compared to how much the claim actually cost a client on the incumbent PBM’s network.

To transition from this first set of results to the ROI calculator, we run the data through three layers of data aggregation.

First, we aggregated all of the average AWP results into 3 PBM type categories based on our internal competitive research and the Deutsche Bank, The Wall Street View of the PBM Space, February 2016 report. The 3 PBM type categories we established are:

  • Large PBM
  • Mid-market traditional PBM
  • Pass-through PBM

Second, for each group we calculate an average AWP discount for SmithRx as well as for the incumbent PBM for the following drug categories:

  • Generic
  • Brand
  • Specialty

Third, we then calculate the overall AWP discount by drug category for SmithRx and compare how much better or worse a type of PBM (i.e., Large, Mid-market, Pass-through) performs relative to SmithRx. Finally, we calculate and compare rebates using the same PBM type aggregation method, and present the results as a percentage of total spend, rounded to the nearest ten percent.

Although a user selects a specific PBM and group size from the dropdown list as calculator inputs, SmithRx does not show any data or conclusions regarding a specific PBM or group. Results of a comparison between SmithRx and an individual PBM and results for a specific group may differ significantly from those based on the aggregated PBM data and general group size.