SmithRx Blog

Education

What is a PBM Admin Fee?

Learn what a PBM admin fee is, how it compares to other PBM-related fees, and why understanding these costs can help employers and brokers choose the right Pharmacy Benefit Manager.

Product Updates

SmithRx Partner Portal 2.0: Supercharging Your PBM Success

SmithRx Partner Portal 2.0: Discover enhanced PBM tools for streamlined analytics, reporting, and client management. Boost efficiency and drive success with our newly refreshed platform.

Education

Pharmacy Benefit Reform Is Coming - Is Your Organization Ready?

Learn how HR leaders can navigate PBM reform and modernize prescription benefits.

Education

Navigating PMPM: Understanding its Meaning and Impact in Healthcare

Learn how PMPM–Per Member Per Month–impacts self-insured employers and pharmacy benefits management strategies, and find out how PMPM influences healthcare cost management.

Education

Brand-Name vs. Generic Drugs: Understanding the Key Differences

Confused about generic vs. brand-name drugs? Discover key differences in price, ingredients, and effectiveness. Learn how to make informed choices for your health and wallet.

Education

Slash Your Rx Costs: 8 Ways to Save Big on Meds

Beat skyrocketing drug prices with our expert tips. Learn how to slash your prescription costs and save money without compromising your health.

Education

Decoding Drug Labels: 10 Essential Tips for Medication Safety

Master medication safety by understanding drug labels. Learn 10 key label components, get pharmacist consultation tips, and manage prescriptions easily with SmithRx. Empower your health through proper medication knowledge.

Education

Transforming the PBM Landscape: Highlights from the Inaugural Broker Account Manager Summit

SmithRx's first Broker Account Manager Summit in Dallas united industry professionals for intensive learning and networking.

Case Studies

St. Mary’s School

Read this case study to discover how St. Mary’s School reduced Rx costs by 60% and saved over $100K with SmithRx’s transparent pharmacy benefits solution.

Education

How do PBMs Determine Prescription Drug Pricing?

Understanding how PBMs determine prescription drug prices can help you choose who to work with. Learn more about PBM drug pricing here.

Education

4 Practical Steps for Employers to Lower Prescription Costs

Discover effective strategies for employers to help reduce prescription drug costs for their workforce. Learn about generic medications, optimizing insurance plans, and utilizing discount programs to better manage healthcare expenses.

Education

AWP vs. WAC: What’s the Difference?

Learn the differences between AWP vs. WAC here, and find out why they matter when it comes to your company’s pharmacy benefits.

Education

8 Ways Employers Benefit from Low-Cost Prescriptions

Find out how employers benefit from low-cost prescriptions, and see how working with the right PBM can lower spend on drug and treatment costs for your business.

Education

Legacy PBM Fee Structures: 4 Tactics That Hide True Costs

Discover how legacy PBMs hide true costs through complex fee structures. Learn about SmithRx's transparent pricing model that offers a simpler, more cost-effective alternative to traditional PBM services.

Education

Experts Weigh in on the Clinical and Business Impact of GLP-1s

How important is it for plan sponsors to cover GLP-1s? We asked experts to share their advice and insights on the trending medication.

Education

6 Ways Legacy PBMs Put Employers at Risk

Learn how legacy PBMs put employers at risk, from using outdated practices to keeping costs hidden—and discover how switching to a modern PBM can protect your business and employees.

Education

What is Spread Pricing?

Discover how spread pricing in PBMs can inflate drug costs for self-insured employers. Learn strategies to mitigate its impact and choose a transparent PBM partner like SmithRx.

Education

PBM Formulary: What is Closed vs. Open?

Discover the key differences between closed and open formularies and their impact on healthcare costs. Learn how these formulary types affect your medication access and influence cost management strategies.

Education

The Ultimate List of Questions To Ask a Benefits Broker

Working with a benefits broker can improve the quality of the benefits offered to employees. Learn the top questions to ask a Benefits Broker here.

Education

What Brokers and Employers Need to Know About GLP-1s

GLP-1s manage diabetes and aid weight loss but are costly due to high demand. Employers face challenges balancing coverage and costs. Strategic planning and transparent partnerships can help manage these expenses effectively.

Education

Common Cardiometabolic Diseases: Overview, Prevalence, and GLP-1 treatment Impact

Discover the growing impact of cardiometabolic diseases like diabetes and cardiovascular disease on healthcare costs. Learn how GLP-1 treatments, such as Ozempic®, are reshaping pharmaceutical demand and benefit management. Find out what brokers and employers need to know to make informed healthcare plan decisions and manage costs effectively.

Announcements

An Open Letter to SmithRx Customers Regarding Recent PBM News

SmithRx CEO Jake Frenz addresses recent news coverage scrutinizing traditional PBM practices. He highlights how SmithRx's transparent, client-focused approach differs from legacy PBMs.

Education

The Imperative Evolution of PBMs: 6 Modern Answers to Legacy Challenges

Discover six crucial areas where modern PBMs are redefining the industry, offering insights into how these innovations are creating more transparent, efficient, and client-focused pharmacy benefit solutions.

Education

How To Evaluate Your Pharmacy Benefit Manager (PBM)

Learn how to evaluate your PBM partner to get the most savings possible. Discover what to look for in a current or potential PBM partner here

Education

Mail-Order Markups by Big PBMs Drive Up Drug Costs for Employers

A recent Wall Street Journal article reveals unexpected cost increases from mail-order pharmacies. Our blog highlights key issues for brokers and plan sponsors, including rising drug costs and choosing a conflict-free PBM.

Education

3 Things About PBMs That Need To Change

US healthcare is broken, and large pharmacy benefit managers (PBMs) are to blame. Here are three key problem areas that need to change.

Education

Why PBM Contracts Are to Blame for High Drug Prices

Discover why drug prices keep rising in America. Learn how Pharmacy Benefit Managers (PBMs) and their discount-based contracts contribute to skyrocketing costs, impacting your wallet and healthcare.

Education

The Paradox of Cost-Based vs. Discount-Based PBM Evaluation Methods

Explore the paradox between cost-based and discount-based PBM evaluation methods. Learn why cost-based evaluation, which focuses on actual drug costs, leads to lower expenses and greater transparency, optimizing overall pharmacy spend.

Education

What Is a PDL? Understanding the Role of Prescription Drug Lists

Learn how PDLs impact coverage and costs for self-insured employers and employees and their role within pharmacy benefit management.

Education

What Is a Formulary? Understanding Prescription Drug Lists

Discover what a formulary is, how they are created, and how formularies can make managing your prescriptions more convenient and cost-effective.

Case Studies

International Beverage Distribution

Learn how an international beverage distribution company reduced PMPM costs by 27% thanks to Gallagher and SmithRx

Education

Tackling Monopolistic Practices in Pharmacy Benefits Management: Insights from FTC Chair Lina Khan

FTC Chair Lina Khan discusses the harmful impact of anti-competitive practices in the PBM industry on CBS This Morning. She highlights the urgent need for greater transparency and the risks of vertical integration.

Product Updates

Enhancing the Member Experience: Introducing the Prior Authorization Status Feature

The prior authorization process can be frustrating. Read more about how SmithRx makes the process more streamlined and transparent with real-time details.

Education

The Cost of Discount-Focused PBMs: A Case Study of Johnson & Johnson's Prescription Drug Pricing

Uncover the significant price difference between Johnson & Johnson's plan with PBM Express Scripts and SmithRx's cost-effective approach. Find out how our solutions can save on prescription costs.

Education

Mark Cuban’s Top 3 Lessons for Benefits Brokers

At this year’s Brown & Brown “Benefits Evolved” event in Dallas, SmithRx Founder and CEO, Jake Frenz, took the stage with Mark Cuban to discuss how brokers can reshape the healthcare landscape. 

Case Studies

TLC Property Management

Explore the success story of TLC Property Management, SmithRx, and the Tedrick Group in overcoming soaring pharmacy benefits costs while enhancing employee satisfaction.

Product Updates

Introducing Cost Savings for MS Medications with Mark Cuban Cost Plus Drugs

SmithRx's newest Connect 360 program for Multiple Sclerosis ensures members can receive their medication at no cost, while employer groups enjoy upfront savings ranging from 72-99.8%.

Education

Unraveling PBM Complexity: The Consequences of Vertical Integration

The "Big Three" PBMs are well-known for their vertical integration strategies, which have significantly transformed the healthcare market, often to its detriment.

Education

Big 3 PBMs Surpassed by Alternative PBMs, New Survey Reveals

The latest PBM Customer Satisfaction Report from the Pharmaceutical Strategies Group (PSG) presents findings that are clear signals of a significant industry shift. 

Product Updates

Connect 360: Revolutionizing Prescription Savings

SmithRx’s Connect 360 reduces drug costs for a wide range of prescription drugs — all for a low flat fee. Learn how brokers, employers, and members can benefit.

Education

Unraveling PBM Complexity: Maximum Allowable Cost (MAC) Lists

MAC list arbitrage occurs when PBMs take advantage of price differences, which can make prescription medications more expensive for employers. In this piece, we'll break down how MAC list arbitrage affects budgets and healthcare costs.

Education

Unraveling PBM Complexity: Transparent PBM Contracts vs 100% Pass-Through Contracts

In this article, we define the difference between transparent and pass-through contracts. While often used interchangeably, they represent two distinct aspects of PBM operations. 

Series C Success: A $60 Million Leap Towards Transforming Healthcare

Today we’re excited to share a pivotal milestone in our journey at SmithRx: our $60 Million Series C financing round.

Education

Big Health’s Threat to Community Pharmacies & Why it Matters

Community pharmacies, central to local health and economy, face challenges from the rise of large healthcare conglomerates. This shift threatens to increase costs, limit choices, and lower healthcare quality.

Announcements

SmithRx & Amazon: Simplifying Your Healthcare Experience

SmithRx is now offering Amazon Pharmacy as a home delivery option for your medications. Learn how to get a hassle-free experience that saves you time and money.

Education

How To Explain What’s Wrong with US Healthcare to Your Family Over the Holidays

Every American knows that our healthcare system is broken. We all feel the frustration of dealing with the confusing paperwork, archaic systems, and ever-increasing costs. Why is this happening?

Announcements

SmithRx in 2023: A Year of Pioneering Truly Transparent Pharmacy Benefits

2023 was a year about demonstrating true transparency in pharmacy benefits management. It was about nurturing an experience that consistently puts our clients and members first.

Education

Unraveling PBM Complexity: Revealing Information Asymmetry & Hidden Fees

In this post, we aim to equip you with some of the insights and tools needed to discern the realities of Pharmacy Benefit Manager practices, ensuring that your decisions are informed and your healthcare management is as cost-efficient and (truly) transparent as possible.

Education

Smoke and Mirrors: Analyzing CVS’s Drug Pricing Revamp

In the wake of CVS Health's recent announcement to revamp its drug pricing model, those of us in the pharmacy benefits management world are compelled to examine these changes with a critical eye.

Product Updates

Product Announcement: A Refreshed SmithRx Member Portal

The SmithRx member portal is designed to put you in control of your own health. Here’s a refresher on a few of the things you can do (or access) in the portal.

Education

The Flaws in Cigna’s New Cost-Plus Model

As the SVP of Product Strategy at SmithRx, I've been closely following Cigna’s announcement about their new “cost plus” pharmacy network.

Education

Traditional PBMs Capitalize On GLP-1 Drug Frenzy

Once Again, the Financial Burden Falls on Employers and Patients

Announcements

Introducing A New Pharmacy Benefit: Amazon Pharmacy

Good news: Amazon Pharmacy is now available to all SmithRx members.

Announcements

Updates to the SmithRx Low-Cost Insulin Program

SmithRx is forging new pathways to make insulin more affordable. The SmithRx Low Cost Insulin Program decreases the cost of insulin at the pharmacy for employer groups and members.

Education

How Pass-Through Pricing Causes Traditional PBM Clients to Lose

Big PBMs like OptumRx, Caremark, Prime, and Express Scripts have heard the market demand

Education

TransparencyRx & the Mission to Fix Broken Drug Pricing

The demand for transparency and affordability in prescription drug pricing has never been more critical.

Education

The Top 6 Tactics Used to Hide PBM Fees

Big PBMs have become the masters of generating massive profits using hidden fees. This is how Caremark, the PBM owned by CVS, generated more profit

Announcements

Press Release: 9amHealth & SmithRx to Provide High-Quality & Cost-Effective Cardiometabolic Solutions

SmithRx's new Connect Care offering, in partnership with 9amHealth, will provide patients with prevention and lifestyle interventions

Announcements

Press release: New coalition of Transparent PBM companies seeks to fix nation’s broken drug pricing system

Transparency-Rx embraces Congressional reform, as a catalyst of changes to the PBM market

Case Studies

SmithRx Drives $35 PMPM Savings for Montana Credit Union League Group Benefit Trust

There are always new opportunities to save on drugs. We appreciate the continuous innovation especially as the market evolves and programs change.

Education

Uncovering Hidden Costs in AWP & Rebate Discounts

At SmithRx we think about pharmacy benefits through the lens of self-insured employers. What these employers want is lower pharmacy costs

Education

SmithRx Clients Drug Costs Remain Significantly Below Industry Benchmarks

While drug costs are increasing rapidly, SmithRx’s clients see pharmacy costs fall or remain flat

Education

Navigating PBM Deals with Blue Shield as a Self-Insured Business

The Big 3 PBMs manage thousands of “MAC lists” which enable them to charge different prices for the same drug

Announcements

Press Release: TheracosBio & SmithRx Collaborate to Offer Newly Approved Diabetes Drug Brenzavvy™

TheracosBio and SmithRx, a next-generation pharmacy benefits management (PBM) company

Education

Understanding Your Prescription Costs

Have you ever gone to pick up a prescription and been surprised by the cost (either more or less than you expected)?

Education

What is a Biosimilar?

With new biosimilars for Humira available this year, many of you have had questions about biosimilars

Product Updates

Introducing: Find My Meds

We take comparison shopping for granted in most areas of our life. Thanks to Amazon, Google, and others

Education

How Legacy PBMs Play Games with Humira Biosimilars

On January 31, 2023, Amgen released Amjevita, the first biosimilar for AbbVie’s Humira.

Announcements

SmithRx: The First PBM to Offer a Humira Biosimilar

Teaming up with Mark Cuban Cost Plus Drug Company, SmithRx will start offering members Yusimry beginning in July 2023

Announcements

Introducing SmithRx’s Low-Cost Insulin Program

SmithRx is forging new pathways to make insulin more affordable. Starting July 1, 2023, biosimilar insulin products manufactured by Lilly

Announcements

SmithRx & Mark Cuban Cost Plus Pharmacy Team Up to Reduce Medication Costs

Mark Cuban Cost Plus Drug Company (Cost Plus Drugs) has joined the SmithRx pharmacy network!

Education

SmithRx Transparency: The Consolidated Appropriations Act (CAA) 2021

At SmithRx, we’re all about transparency and passing through savings for prescription drug coverage.

Education

A New Consumer-Centric Approach to Healthcare

As healthcare costs continue to rise, employers and plan sponsors are continually being pressed to find solutions.

Education

Is there a “Twindemic” upon us?

As the world battled the COVID-19 pandemic in 2020 and 2021, with heightened measures to quarantine and social distance

Announcements

The end of an era

After nearly two decades of patent exclusivity and $200 billion in sales

Education

The Ozempic Shortage Explained

Ozempic, manufactured by Novo Nordisk, is a medication FDA approved for treatment of type 2 diabetes.

Announcements

SmithRx Announces $20 Million Series B Led by Venrock

SmithRx, a next-generation pharmacy benefits management company, today announced the closing of a $20 million series B financing round

Announcements

SmithRx & EIHR: A Guide to Pharmacy Benefits

The use of Pharmacy Benefits Managers (PBMs) is the most common method implemented by employers to facilitate providing

Education

What is a Drug Acquisition Platform, and how is it different from a traditional PBM?

Pharmacy benefit managers (PBMs) were established in the 1980’s as a solution to facilitate the electronic transaction

Education

How to Evaluate Your PBM’s Performance Guarantees

We have previously discussed the standard methods used to evaluate PBMs and how contract definitions can impact PBM accountability in complex ways.

Education

A Visual Explanation of High Drug Prices in the US

It’s clear to most Americans that our medical costs are higher than they should be, and that drug prices in particular are growing out of control.

Education

PBM contract guarantees 101: network discounts and manufacturer rebates

We are approaching the last quarter of the year which means renewal season for many self-funded employers.