Hospitals & Health Systems

Customized Hospital & Health Care System plans reap savings others miss

We have deep understanding of this industry and the specific and unique needs of Hospital & Health Care Systems. We analyze the data and determine potential drug cost savings and revenue opportunities such as increased utilization of in-house pharmacies, 340B optimization, dispensing of specialty drugs, maximizing copay assistance and alternate funding. We decipher the contract language and plan design structure, exposing your plan’s true value: its deficiencies, hidden fees, and real-world effects on plan members and your overall pharmacy benefit costs.

Advantage to You

We assist in enhancing PBM contract language to take advantage of all the medical and pharmacy services offered by the Health Care system which can lead to real savings and better health outcomes for your members.

PBIRx Services

• In-house pharmacy assessment & optimization
• Hospital purchasing negotiation & reimbursement rate structure to PBM
• Aligning hospital’s formulary, i.e. 340b with PBM formulary
• Copay structure review for optimization & potential steerage to in-house utilization
• Mail order courier service – (to other areas)
• Specialty pharmacy delivery – (current structure, development of program, migration to 340b)
• Consider private label PBM service
• 340b policy & procedure guidance and documentation
• 340b HRSA mock audit
• 340b software vendor RFP services & oversight