When it comes to pharmacy benefits management, many brokers and consultants stay firmly within their comfort zones, automatically including the big three pharmacy benefit management (PBM) firms during their request for proposal (RFP) process. But the problem with comfort zones is that they breed complacency and exclude innovation. And frankly, the employers you work with deserve more from their benefit advisors. 

Typical PBMs have a backwards view of the pharmacy benefit management process, making formulary decisions based on price and rebates, rather than what is best for the patients. In fact, pharmacy benefits managers have become pharmacy profit managers. The entire pharmaceutical ecosystem is fractured, with hidden fees baked into contracts and employees treated like problems to be managed. 

If the contract you're reading doesn't include the sentence, "We will charge what we pay the pharmacy," employers can fall victim to spread pricing, hidden rebate fees and high-cost formularies.