Read: Reference-based pricing: where do carriers go from here? 
pharmacy benefit manager - Do they have a contract specific to their pharmacy benefit?
- Does their contract clearly list out the discounts/fees/rebates that are applied to your claims utilization?
- Does their contract clearly define under what circumstances those discounts/fees/rebates are applied to their claims?
- Does their contract clearly state what detailed information they will have access to relative to their claims utilization and experience?
- Does their contract contain audit rights that allow them to validate that their carrier or PBM is compliant with their financial obligations under the contract?
Cory Easton is a Partner at Confidio, a technology enabled pharmacy benefit consulting firm serving millions of members nationally. For more information please visit: www.confidio.com or to reach the author, please email him: [email protected] .
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