If you’re reading this and work in HR or finance for a self-funded employer, never retain the services of a broker or PBM consultant who benefits when your pharmacy costs increase. Should you do so, be sure to have signed a conflict of interest disclosure form.
- Do you have the expertise within your company to evaluate PBM contract language?
- Do you have the skillset to design a pharmacy benefit plan? Or do you need additional training in pharmacy benefits management?
- Do you have the expertise and resources to manage the plan design or do you need to build in the incentives for the PBM to manage your program?
- How do you want to be involved in the management of the plan after it is set up?
In other words, hire consultants not because you lack the requisite knowledge to design or manage the pharmacy benefit plan in-house, but because you lack the time or human capital to go it alone. Plan sponsors might be surprised to learn that many so called advisers know little more than they do or worse have misaligned incentives. Who is watching the watcher?
