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 a pharmacy benefit to their employees and dependents. Unfortunately, for these employers the inner workings of a PBM are a black box filled with misaligned incentives and no real insight into the true cost of medications. As a result employers rely on multiple stakeholders to provide truthful and accurate information to help them manage costs. Through this process employers are subjected to asymmetric market information and are often left not truly knowing if they are getting a good deal.

SmithRx, in collaboration with EHIR and other forward-thinking PBMs, created a set of guiding principles to help bring clarity to this otherwise opaque process. The results of this collaboration are two documents designed to help drive exploration by employers into alternative paths more closely aligned with their interests and goals. This guide to pharmacy benefits can be used as a reference to drive meaningful conversations between employers and their consultants or benefit advisors as they move through the PBM evaluation process.

Seeking Alignment and Transparency from PBMs - An outline of areas often overlooked in the PBM evaluation process. This guide provides highlights of these areas and summaries of why they should matter to you as an employer.‍

Employers Guide to Pharmacy Benefits: Tips for Ensuring that Your Company Is Getting a Fair Deal - Designed to help employers think about upcoming PBM projects including RFPs, selection of a pharmacy consultant, and mid-contract reviews of current vendors. This guide contains sample questions that could be added to RFIs or RFPs to elicit information that will support finding a PBM partner that is most aligned with the interests of your organization.

SmithRx is committed to providing pharmacy benefit services in a way that employers deserve. We are hyper-focused on reducing pharmacy costs by reimagining the traditional PBM as a Drug Acquisition Platform built on transparent modern technology that aligns with the needs of our customers. The result is a better experience for members and truly lower pharmacy costs for employers. Get in touch with a SmithRx team member to learn more about how to navigate the world of PBMs.