Are you overpaying for your Prescription Drug Plan ?
If you decided on a vendor through a traditional RFP process or spreadsheet re-price then the answer is a definite yes. Worse yet, because of contract limitations on audits and proprietary definitions you will not know how much you overpaid.
Prescription drug costs are controlled by the Pharmacy Benefit Manager's (PBM) contract. In most cases, the PBM writes the contract and the employer agrees to the boilerplate language. These contracts are invariably written to protect PBM and shareholder profits not to lower costs for employer groups or their employees.
What can you do about it?
First, forget about traditional RFP's and re-pricing as the only mechanism for controlling trend and getting the best price. Begin instead by dictating the terms of the contract! AWP and rebate guarantees are virtually meaningless if the PBM has the freedom to reclassify drugs and claims to meet the guarantees. Contract terms and formulary management mean everything. GLBG can help you manage both while lowering your cost and providing world-class services with broad access for your employees.
For more than a decade Ryan has developed aligned and empowered partnerships throughout the healthcare and PBM industries.
With a primary focus in managed care, commercial, and TPA pharmacy partnerships, Ryan has successfully collaborated to create effective, and highly custom methods of managing the pharmacy benefit. His work has led to substantial plan savings and quality care outcomes on behalf of Fortune 500 corporations, State Government Plans, National Health Plans, and Taft Hartley Funds.
His creative demeanor and analytical discipline make him an aligned advocate for client partners seeking to create innovative solutions with lasting outcomes.
Exposed early on, Ryan quickly learned the PBM industry working in Operations and Account Management while with Express Scripts.
Building on his experiences, he joined Minneapolis based pharmacy consulting firm, The Burchfield Group, leading managed care and national employer procurement and contracting efforts.
Following his time as a consultant, Ryan worked as Strategic Pharmacy Operations Lead for D.C. based healthcare start-up, Evolent Health, where he developed rebate contracts, pharmacy network arrangements, and business development strategies.
Prior to joining Prism Health Strategists & Great Lakes Benefit Group, Ryan led regional sales and business development initiatives for Navitus Health Solutions, serving as Regional Vice President. His appreciation and understanding of the fully pass-through and transparent business model make him an ideal advocate for those seeking a non-traditional pathway to savings.
Ryan earned his Bachelor’s Degree from Drake University.