PRM RISK ASSESSMENT
PROMISE VS REALITY
PROMISE VS REALITY
PROMISE VS REALITY
PROMISE VS REALITY
Determine Current PBM Risk Factors with Three Simple Assessments
ASSESSMENT one
ASSESSMENT one
ASSESSMENT one
Compare Your Top Drugs
Is your PBM actually providing your employees with fairly priced medications and optimizing for low out-of-pocket costs? Are they ensuring the lowest net cost for you as the plan sponsor? Complete your own top drug analysis now.
Top Drug Comparison Worksheet
Top Drug Comparison Worksheet
Top Drug Comparison Worksheet
Tip
How do I check how much I pay for these medications?
How do I check how much I pay for these medications?
1
Ask your PBM account manager
2
Use your PBM portal
*Warning: Some PBMs charge extra for claims-level reporting
Our Promise
TIP
TIP
How do I check how much I pay for these medications?
How do I check how much I pay for these medications?
How do I check how much I pay for these medications?
1
1
1
Ask your PBM account manager
Ask your PBM account manager
Ask your PBM account manager
2
2
2
Use your PBM portal
Use your PBM portal
Use your PBM portal
*Warning: Some PBMs charge extra for claims-level reporting
ASSESSMENT Two
ASSESSMENT Two
ASSESSMENT Two
Calculate Your PMPM
What are your per member per month costs including admin fees, ancillary fees, and drug costs? Find out using this simple calculator.
![](data:image/svg+xml,<svg display="block" role="presentation" viewBox="0 0 40 40" xmlns="http://www.w3.org/2000/svg"><path d="M 0 24 L 24 0 M 0 0 L 24 0 L 24 24" fill="transparent" height="24px" id="zYeSXILHh" stroke-dasharray="" stroke-linecap="round" stroke-linejoin="round" stroke-width="4" stroke="rgb(246, 94, 0)" transform="translate(8 8)" width="24px"/></svg>)
ASSESSMENT Three
Understand Your PBM Evaluation Process and Contract
ASSESSMENT Three
Understand Your PBM Evaluation Process and Contract
ASSESSMENT Three
Understand Your PBM Evaluation Process and Contract
ASSESSMENT Three
Understand Your PBM Evaluation Process and Contract
Did you pay separately for the RFP process or was it subsidized?
Why does this matter?
Beware of "free" RFP offers from pharmacy consultants. These costs (up to $7 PMPM) are often built into the PBM's spread pricing, leading to higher drug costs. What seems free upfront ultimately increases your pharmacy spend.
Is your PBM involved in financial relationships with brokers or consultants?
Why does this matter?
PBMs that have financial arrangements with brokers or consultants can create conflicts of interest. These hidden payments, often passed onto the client, may lead to higher overall costs and reduced transparency in how your plan is managed.
Were all the top bidders for your PBM contract legacy providers?
Why does this matter?
If your consultant only provided legacy PBM options, there is a conflict of interest. Modern PBMs definitively provide the same level of service at lower overall pharmacy costs. Your RFP process is incomplete without these cost-effective alternatives.
Does your PBM contract include AWP and rebate guarantees?
Why does this matter?
Beware of discount-based contracting. Your discounts may increase every year, and yet your PMPM spend may increase as well. This should not happen, and is a clear indication that your PBM contract is not delivering real cost savings.
Did you pay separately for the RFP process or was it subsidized?
Why does this matter?
Beware of "free" RFP offers from pharmacy consultants. These costs (up to $7 PMPM) are often built into the PBM's spread pricing, leading to higher drug costs. What seems free upfront ultimately increases your pharmacy spend.
Is your PBM involved in financial relationships with brokers or consultants?
Why does this matter?
PBMs that have financial arrangements with brokers or consultants can create conflicts of interest. These hidden payments, often passed onto the client, may lead to higher overall costs and reduced transparency in how your plan is managed.
Were all the top bidders for your PBM contract legacy providers?
Why does this matter?
If your consultant only provided legacy PBM options, there is a conflict of interest. Modern PBMs definitively provide the same level of service at lower overall pharmacy costs. Your RFP process is incomplete without these cost-effective alternatives.
Does your PBM contract include AWP and rebate guarantees?
Why does this matter?
Beware of discount-based contracting. Your discounts may increase every year, and yet your PMPM spend may increase as well. This should not happen, and is a clear indication that your PBM contract is not delivering real cost savings.
Did you pay separately for the RFP process or was it subsidized?
Why does this matter?
Beware of "free" RFP offers from pharmacy consultants. These costs (up to $7 PMPM) are often built into the PBM's spread pricing, leading to higher drug costs. What seems free upfront ultimately increases your pharmacy spend.
Is your PBM involved in financial relationships with brokers or consultants?
Why does this matter?
PBMs that have financial arrangements with brokers or consultants can create conflicts of interest. These hidden payments, often passed onto the client, may lead to higher overall costs and reduced transparency in how your plan is managed.
Were all the top bidders for your PBM contract legacy providers?
Why does this matter?
If your consultant only provided legacy PBM options, there is a conflict of interest. Modern PBMs definitively provide the same level of service at lower overall pharmacy costs. Your RFP process is incomplete without these cost-effective alternatives.
Does your PBM contract include AWP and rebate guarantees?
Why does this matter?
Beware of discount-based contracting. Your discounts may increase every year, and yet your PMPM spend may increase as well. This should not happen, and is a clear indication that your PBM contract is not delivering real cost savings.
Resources
Critical PBM Knowledge
Resources
Critical PBM Knowledge
Resources
Critical PBM Knowledge
Resources
Critical PBM Knowledge
Take the Next Steps to Protect Your Team and Organization
Take the Next Steps to Protect Your Team and Organization
Take the Next Steps to Protect Your Team and Organization
Take the Next Steps to Protect Your Team and Organization
Our Blog
Insights and Updates for Plan Sponsors
Aug 1, 2025, 12:15 PM
Education
Why Legacy PBMs Are Still Failing Employers
Legacy PBMs are still failing to evolve and offer effective, patient-first healthcare—leaving employers unsatisfied. Learn more here about legacy PBMs and the future of transparency.
Aug 1, 2025, 12:15 PM
Read More
Jul 25, 2025, 10:21 AM
How Employers Thrive with Self-Funded Plans
Self-funded health plans offer cost savings and flexibility—but only if you have the right PBM partner. Learn how employers are thriving with SmithRx’s transparent, proactive model.
Jul 25, 2025, 10:21 AM
Read More
Jul 15, 2025, 12:00 AM
Education
Biosimilar Adoption: Why Low Uptake is Still a Challenge
Explore barriers to biosimilar adoption, such as PBM practices, regulatory limitations, and provider and patient level friction and learn what employers can do to promote uptake.
Jul 15, 2025, 12:00 AM
Read More
Our Blog
Insights and Updates for Plan Sponsors
Aug 1, 2025, 12:15 PM
Education
Why Legacy PBMs Are Still Failing Employers
Legacy PBMs are still failing to evolve and offer effective, patient-first healthcare—leaving employers unsatisfied. Learn more here about legacy PBMs and the future of transparency.
Aug 1, 2025, 12:15 PM
Read More
Jul 25, 2025, 10:21 AM
How Employers Thrive with Self-Funded Plans
Self-funded health plans offer cost savings and flexibility—but only if you have the right PBM partner. Learn how employers are thriving with SmithRx’s transparent, proactive model.
Jul 25, 2025, 10:21 AM
Read More
Jul 15, 2025, 12:00 AM
Education
Biosimilar Adoption: Why Low Uptake is Still a Challenge
Explore barriers to biosimilar adoption, such as PBM practices, regulatory limitations, and provider and patient level friction and learn what employers can do to promote uptake.
Jul 15, 2025, 12:00 AM
Read More
Our Blog
Insights and Updates for Plan Sponsors
Aug 1, 2025, 12:15 PM
Education
Why Legacy PBMs Are Still Failing Employers
Legacy PBMs are still failing to evolve and offer effective, patient-first healthcare—leaving employers unsatisfied. Learn more here about legacy PBMs and the future of transparency.
Aug 1, 2025, 12:15 PM
Read More
Jul 25, 2025, 10:21 AM
How Employers Thrive with Self-Funded Plans
Self-funded health plans offer cost savings and flexibility—but only if you have the right PBM partner. Learn how employers are thriving with SmithRx’s transparent, proactive model.
Jul 25, 2025, 10:21 AM
Read More
Aug 1, 2025, 12:15 PM
Education
Why Legacy PBMs Are Still Failing Employers
Legacy PBMs are still failing to evolve and offer effective, patient-first healthcare—leaving employers unsatisfied. Learn more here about legacy PBMs and the future of transparency.
Aug 1, 2025, 12:15 PM
Read More
Jul 25, 2025, 10:21 AM
How Employers Thrive with Self-Funded Plans
Self-funded health plans offer cost savings and flexibility—but only if you have the right PBM partner. Learn how employers are thriving with SmithRx’s transparent, proactive model.
Jul 25, 2025, 10:21 AM
Read More
Jul 15, 2025, 12:00 AM
Education
Biosimilar Adoption: Why Low Uptake is Still a Challenge
Explore barriers to biosimilar adoption, such as PBM practices, regulatory limitations, and provider and patient level friction and learn what employers can do to promote uptake.
Jul 15, 2025, 12:00 AM
Read More
SmithRx is on a mission to reduce the complexity and costs of pharmacy benefits with radical transparency and cutting-edge technology.
Sales and Business
Pharmacy and Provider Line
Member Help
Connect
Awards
SmithRx is on a mission to reduce the complexity and costs of pharmacy benefits with radical transparency and cutting-edge technology.
Sales and Business
Pharmacy and Provider Line
Member Help
Connect
Awards
SmithRx is on a mission to reduce the complexity and costs of pharmacy benefits with radical transparency and cutting-edge technology.
Sales and Business
Pharmacy and Provider Line
Member Help
Awards
Company
Resources
Connect