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Opt-e-scrip
Will Act as Your Fiduciary
Historically, PBMs came into existence to administer the prescription
drug benefit at the lowest possible cost for at-risk health plans. Today, pharmaceutical manufacturer
rebates, the profit made by retaining a “spread” between what
the client is charged and what the retail pharmacy receives for dispensing
a drug, and the profit opportunity from dispensing drugs through the
PBM’s own mail-order pharmacy have created a broadly-recognized
conflict of interest between PBM’s and their clients. As a result, in many cases higher drug
utilization is better for the PBM because the PBM is no longer simply
administering the drug benefit, but is also, in effect, buying drugs at
wholesale and selling them at retail.
To deal with this
issue, Opt-e-scrip will contractually commit to act as your fiduciary
in the administration of your drug benefit plan. We believe we are one of the first to do
so in the industry.
Accordingly, we
adhere to the following principle: Whenever
there is an unanticipated conflict-of-interest situation that arises from
which we could benefit financially at your expense, we will resolve the
situation in your favor.
We
will also represent and warrant that we adhere to the following business
practices, which most PBM's will not follow:
·
To
charge employers the same amount that Opt-e-scrip
is charged by the dispensing pharmacy for brand and generic drugs
delivered at retail;
·
To
provide acquisition cost of brand and generic drugs delivered via mail
order;
·
To
pass through any and all payments received by Opt-e-scrip from
pharmaceutical manufacturers that are based on a client’s drug
utilization, including rebate dollars and revenue for data sales and
marketing studies associated with drug utilization;
·
To
allow client audits of our supplier contracts, including those with
pharmaceutical manufacturers, to verify compliance;
·
To
provide the capability to administer point-of-sale rebates to clients;
·
To
design programs and services to help manage chronic conditions to meet
employer and individual employee needs; and
·
To
promote greater use of appropriate cost-effective medications.
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