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What is a Pharmacy Benefit Management Consultant?

A Pharmacy Benefit Management Consulting Firm provides solutions to help reduce prescription medications costs and challenges by analyzing every aspect of a client’s PBM program.  PBM Consultants work with self insured employer groups, government entities, union funds, third party administrators (TPA’s) and PBM’s. VPS provides all of the following consultative functions:

  • PBM Contract Analysis
  • Clinical Cost Saving Analysis
  • Improved Adherence
  • Personalized Member Engagement
  • Targeted Employee Communications
  • Manage Prescription Pharmacy Trend
  • Provide a Seamless Implementation
  • Provide Health Care Reform Compliance Program
  • Provide a Designated Account Management Team
  • Provide Monthly Reporting and Face to Face Quarterly Reviews
  • Negotiate Contracts on behalf of the Client
  • Perform Audits

The power of the Coalition

gives you large group pricing

We Offer Flexible Solutions to Substantially Reduce Your Organization’s Pharmacy Benefit Management (PBM) Spend

By creating economies of scale, members are able to leverage market-leading pricing and substantial savings (7 to 20% annualized) with flexibility in plan design.

The Rapidly Changing Pharmacy Landscape

VPS helps navigate through the continuously shifting prescriptions options. We scrutinize how market changes affect your company’s bottom line.

VPS Philosophy Affords Your Company the Following Attributes

  • RX Coalition Pricing
  • Plan Evaluation & Savings Analysis
  • Executive Account Management
  • PBM Contracts
  • Vendor Managment

Reduce Costs without sacrificing plan quality

Pharmacy program costs continue to increase at double-digit rates. Our contract negotiation and management solutions allow clients to save the maximum amount  on contract administration costs. In addition, our clinically focused utilization management tools allow clients to manage trend to levels much better than national averages.

Don’t Sacrifice The Quality of Your Plan

The VPS Consulting Team implements innovative approaches to help clients reduce their current and future pharmacy spend. VPS helps clients reduce pharmacy costs by:

  • Providing access to Coalition Pricing: Midsize and larger groups have access to pricing based on 150,000 lives.
  • VPS has developed preferred PBM vendor relationships to secure the most competitive pharmacy contracts and discounts while maintaining contract flexibility. VPS and its PBM vendors provide the largest pharmacy networks in both retail and mail order.

Focus: Managing Speciality Drug Spend

Over 50% of Specialty costs are hidden in the medical benefit with minimal employer insight into what the actual costs are.

Valued Pharmacy Services provides clients with the focus and management necessary to maintain awareness of this trend and associated costs. At VPS we use exclusive Specialty distribution channels to maximize the best rates in the network. One hundred percent of our members are reviewed monthly to make sure that they have received appropriate prior authorizations, step therapies and enrollment into case management programs.
In addition, we work with your health care plan to evaluate specialty claims being paid under the medical benefit with an eye toward recommendations and potential savings if these drugs fall under the discounts and management offered by your pharmacy benefit.
Our “hands on” approach analyzing client spend in concert with current market trends is just one approach to ensure Specialty Costs do not take you by surprise.

Improve Outcomes

through claims evaluation and management

Adverse drug reactions. Overuse. Noncompliance. Each of these issues can be present in pharmacy benefit programs. Our team designs and implements programs that allow you to identify and correct these and other clinical issues that might be apparent in your plan. The result is a pharmacy benefit program that delivers improved outcomes for your plan participants.

Improving Health, Reducing Total Cost

VPS provides proven competitive advantages in the areas of greatest concern and delivers tangible RX results.

VPS can provide the following programs to assist plan sponsors and members:

  • Monthly reporting to plan sponsor, broker, consultant and TPA with 24/7 access to reporting system.
  • Quarterly management reports and reviews that provide in depth reporting and observations that provide a more accurate picture of plan utilization and outcomes for members.
  • A comprehensive clinical approach that addresses clinical recommendations and expertise with:
    • Pharmacy Trends
    • Specialty Medication
    • Strategic clinical opportunity  analysis and Chronic Condition Management Strategies

Save Time… less administration for plan sponsors, brokers, consultants and TPA’s

Pharmacy program costs continue to increase at double-digit rates. Our contract negotiation and management solutions allow clients to save on contract administration costs. In addition, our clinically focused utilization management tools allow clients to manage trend to levels much better than national averages.

Focus On Healthier, More Productive Employees

VPS assigns a dedicated Account Management Team to work closely with the plan sponsor through the sale, implementation, and ongoing customer guidance process. These no cost, value added benefits provided by the VPS Account Management Team includes:

  • Guidance on Formulary
  • Monthly and Quarterly Reporting and Evalution
  • Pharmacy Network Administration
  • Network Development and Pharmacy Recruitment
  • Guidance on Clinical and Trend Management Programs
  • Provides Ad-hoc Reporting when requested
  • Assists in Development of Specialty Pharmacy Strategy
  • Works closely with the TPA’s on behalf of the Client through Implementation and Ongoing
  • VPS Manages Cost and Services Post PBM Selection

 Contact VPS to see how we can benefit you.

 
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