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Pharmacy
Pharmacy analytics
MEMBER COST SHARE/SPECIALTY
Similar to medical, because most hospital clients are • Specialty drug predictive modeling tools
a purchaser and provider of pharmaceuticals, they are • Focus on medication adherence
able to: improvement
MEMBER DETAILED
• Leverage domestic pharmacies COST-SHARE CLAIMS OBJECTIVE AND TRANSPARENCY
• Utilize in-house clinical resources STRATEGIES ANALYSIS • Rigorous inancial valuation of proposals
• Not limited to Lockton collectives
• Align the PBM with the outpatient • Winning PBM must agree to client’s
formulary contractual provisions, guarantees, and
• Create in-house mail order SPECIALTY DRUG independent audits
SPEND
pharmacies MITIGATION PBM PROSPECTIVE COST MODELING
• Client-focused RFP
• Utilize 340B pricing, if MARKETING • Focus on key metrics
applicable Lockton Pharmacy • Financial and technical analysis
• Steer through plan design Analytics • Finalist meetings (as needed)
and networks CLINICAL
SAVINGS CONTRACT OPTIMIZATION
• Optimize and steer J-Code ANALYSIS PROSPECTIVE • Establish clear contractual deinitions
drugs domestically COST MODELING • Structure $ for $ Performance Guarantees
• Focus on a higher level of • Structure objective audit procedures
pricing transparency • Deine clear algorithms for guarantee and
penalty calculations
• Utilize domestic infusion clinics and FORMULARY CONTRACT FORMULARY AND NETWORK
resources MANAGEMENT OPTIMIZATION ANALYSIS AND RECOMMENDATION
• Specialty carve-out opportunities
(e.g., hemophilia)
Western Wisconsin Health — Lockton Total Rewards Practice overview 36 Lockton Companies
Pharmacy analytics
MEMBER COST SHARE/SPECIALTY
Similar to medical, because most hospital clients are • Specialty drug predictive modeling tools
a purchaser and provider of pharmaceuticals, they are • Focus on medication adherence
able to: improvement
MEMBER DETAILED
• Leverage domestic pharmacies COST-SHARE CLAIMS OBJECTIVE AND TRANSPARENCY
• Utilize in-house clinical resources STRATEGIES ANALYSIS • Rigorous inancial valuation of proposals
• Not limited to Lockton collectives
• Align the PBM with the outpatient • Winning PBM must agree to client’s
formulary contractual provisions, guarantees, and
• Create in-house mail order SPECIALTY DRUG independent audits
SPEND
pharmacies MITIGATION PBM PROSPECTIVE COST MODELING
• Client-focused RFP
• Utilize 340B pricing, if MARKETING • Focus on key metrics
applicable Lockton Pharmacy • Financial and technical analysis
• Steer through plan design Analytics • Finalist meetings (as needed)
and networks CLINICAL
SAVINGS CONTRACT OPTIMIZATION
• Optimize and steer J-Code ANALYSIS PROSPECTIVE • Establish clear contractual deinitions
drugs domestically COST MODELING • Structure $ for $ Performance Guarantees
• Focus on a higher level of • Structure objective audit procedures
pricing transparency • Deine clear algorithms for guarantee and
penalty calculations
• Utilize domestic infusion clinics and FORMULARY CONTRACT FORMULARY AND NETWORK
resources MANAGEMENT OPTIMIZATION ANALYSIS AND RECOMMENDATION
• Specialty carve-out opportunities
(e.g., hemophilia)
Western Wisconsin Health — Lockton Total Rewards Practice overview 36 Lockton Companies
