At Crystal Clear Rx, we offer customized services, operating on the principle of Continual Rx Value Improvement. Pharmacy utilization, costs and PBM practices are constantly changing. Our approach cuts through the complexities and brings clarity to your PBM contracts so you too can achieve significant, lasting savings for your company. Below, we’ve listed our process and available products, designed to meet your needs at any stage in your PBM contract.
We look at how your current expenditures and Rx contract compare to the marketplace. We’ll determine if you’re paying more than you should, assess your PBM’s performance and compare average ingredient cost, dispensing fees, AWP discounts and MAC dispensing rates to industry benchmarks.
We work directly with your PBM to carefully inspect performance and determine their level of compliance when compared to contractual financial guarantees.
We provide expert consulting to help you identify if a new contract or PBM is needed and what options you have. We’ll discuss the pros and cons of conducting a formal RFP versus a renegotiation or more limited PBM review. Should certain services, such as specialty pharmacy, be carved away from a PBM vendor, our team will work with you to find the best solution and execute a contract that holds all vendor(s) accountable for your company’s best financial interest.
Once a contract with a PBM is negotiated, there is a need to review and determine if the PBM and/or any contracted vendors are meeting their financial obligations. Quarterly checks on PBM and vendor performance against contractual financial guarantees will ensure you are optimizing your spend every step of the way. If your vendor is not in compliance, we will work with you to determine next steps to optimize your plan.
Our simplified, actionable reports, keep you less dependent on your PBM for information. CCRx “de-PBMs” your reports and presents the information from a purchaser’s perspective so you are seeing what is actually happening instead of what the PBM may want you to see. Another advantage to utilizing Crystal View is that the reports don’t change if you change PBMs. We monitor financial and utilization performance, and our reports assist with forecasting, as well as help you better understand utilization patterns and trends.
This program identifies savings opportunities for you, so they can be addressed earlier than the end of a year, or worse, the end of a contract period. When you sign on for Crystal IMPACT monitoring, you receive proactive management of your pharmacy benefit.
This service offers relevant and actionable drug information to help your employees or members move to the most optimal therapies from both a financial and clinical perspective. This may include lower cost alternatives, duplicate therapies and generics. Our goal - to reduce your drug spend!
In addition to our numerous services that offer you assistance at any point in your pharmacy benefit contract, we also provide expert consulting and ongoing monitoring. We want to be your trusted partner and assist you on a monthly, or quarterly basis, to get the most out of your Rx benefit.