The misalignment of interests between a Pharmacy Benefit Manager (PBM) and a business can have significant and far-reaching consequences. When a PBM’s primary focus is on maximizing its own profits rather than optimizing costs for its clients, businesses often find themselves grappling with inflated prescription drug expenses and reduced healthcare efficiency.

One of the most direct impacts is the unnecessary increase in healthcare costs. PBMs with misaligned interests may engage in practices such as spread pricing, where they charge employers more for medications than they pay pharmacies, pocketing the difference. They might also push for the use of higher-cost drugs when equally effective, less expensive alternatives are available. These practices can lead to a substantial financial burden on businesses, affecting their bottom line and potentially forcing them to make difficult decisions about employee benefits or other operational expenses.

Furthermore, the lack of transparency in traditional PBM models can make it challenging for businesses to understand and control their prescription drug spending. This opacity can hinder effective budget planning and limit a company’s ability to make informed decisions about their healthcare strategy.

The ripple effects of these increased costs can extend beyond just financial considerations. Employees may face higher out-of-pocket expenses for their medications, potentially leading to decreased medication adherence. This, in turn, can result in poorer health outcomes, increased absenteeism, and reduced productivity – all of which directly impact a business’s performance and profitability. 

ScriptSourcing stands out in the healthcare cost management landscape by offering innovative solutions that complement, rather than replace, existing PBM relationships. We are not a Pharmacy Benefit Manager (PBM), but rather a specialized service provider focused on alternative medication sourcing options. This unique position allows us to partner with nearly all PBMs, ensuring flexibility and continuity for our clients.

Our expertise in the PBM space enables us to provide valuable insights and analytics to brokers, helping them determine the most suitable PBM for their clients’ needs. We understand that employers often change PBMs every few years, which can lead to disruptions in service and care. To address this, ScriptSourcing has developed an agnostic approach to alternative sourcing services. This strategy ensures that employers receive the best solutions, engagement, and technology, regardless of their chosen PBM.

By offering our services independently of PBM changes, we help employers avoid the disruption typically associated with switching providers. Our model is designed to work seamlessly alongside various PBMs, providing consistent cost savings and improved medication access for employees. This approach not only benefits self-funded employers of all sizes but also creates a stable environment for long-term healthcare cost management and employee satisfaction.