Guaranteed Value Creation

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PBM Negotiator

Achieving Tangible Benefits Through PBM Negotiation

At PBM NEGOTIATOR™, our mission extends beyond compliance and contract management—we are committed to delivering measurable financial value for plan sponsors. Our Guaranteed Value Creation service is designed to secure significant cost savings, enhance service quality, and drive long-term financial efficiency in PBM agreements. By leveraging strategic insights and deep regulatory expertise, we help plan sponsors transform their PBM contracts into a key financial and operational advantage.

What Does Value Creation Mean for Plan Sponsors?

In PBM negotiations, value creation involves optimizing financial and operational outcomes to reduce unnecessary costs, improve pricing transparency, and secure higher rebate pass-throughs. This means negotiating stronger contract terms that eliminate hidden fees, enforce fair cost-sharing structures, and demand high service standards, all while ensuring compliance with federal and state PBM transparency regulations. Our value-driven approach focuses on:

Securing Financial Credits and Rebates: Negotiating higher rebate pass-throughs, eliminating spread pricing, and enforcing price transparency to generate direct financial benefits for plan sponsors.
Enhancing Cost Efficiency: Identifying hidden PBM fees, misaligned rebate structures, and inflated drug pricing to secure cost reductions without sacrificing quality or access to medications.
Optimizing Performance Guarantees: Ensuring that PBM service and pricing metrics align with your organization’s goals, delivering continuous financial and operational value.

Our Proven Process for Value Creation

PBM NEGOTIATOR™’s approach to value creation is systematic, data-driven, and client-focused. Our proven process includes:

Initial Contract Review: A comprehensive analysis of existing PBM agreements to identify pricing inefficiencies, rebate pass-through issues, and cost-saving opportunities.
Strategic Negotiation Planning: Developing a customized negotiation strategy that maximizes financial benefits, aligns contract terms with state and federal regulations, and enhances pricing transparency.
Active Representation: Advocating for plan sponsors during PBM contract negotiations to ensure that pricing terms, rebate structures, and service levels prioritize cost savings and enhanced financial accountability.

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Years of Experience

Our collective experience delivers consistent results.

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Cases

Relevant matters and negotiations, prepared for all the possibilities.

Results that Speak for Themselves

Our Guaranteed Value Creation service has consistently delivered substantial financial and operational benefits for plan sponsors across a wide range of industries. For example, we worked with a large self-funded employer to renegotiate their PBM contract, resulting in a multi-million-dollar reduction in prescription drug costs and the elimination of hidden administrative fees. Additionally, we secured performance-based rebate enhancements, ensuring that rebate pass-throughs were maximized and aligned with plan sponsor interests. This not only improved financial efficiency but also reinforced the organization’s fiduciary responsibility by enhancing pricing transparency and participant protections.

Why Choose PBM NEGOTIATOR™ for Value Creation?

Plan sponsors who partner with PBM NEGOTIATOR™ for value creation benefit from:

Tangible Cost Savings: Achieve significant financial returns through strategically negotiated pricing structures, rebate optimizations, and contract transparency improvements.
Improved Contract Terms: Secure contract provisions that hold PBMs accountable, ensuring pricing integrity, full rebate disclosures, and stronger service-level guarantees.
Long-Term Value: Ensure that PBM agreements continue to drive financial and operational efficiency through ongoing oversight, periodic renegotiations, and proactive contract updates as market and regulatory conditions evolve.

Experience and Expertise You Can Trust

At PBM NEGOTIATOR™, our team combines decades of experience in ERISA, health plan regulations, and PBM contract negotiation. This expertise allows us to identify inefficiencies, eliminate unnecessary costs, and negotiate the most advantageous terms on behalf of plan sponsors, ensuring that every contract contributes to long-term financial stability and strategic success.

Your Path to Guaranteed Value Starts Here

Creating value in PBM agreements isn’t just about reducing costs—it’s about building sustainable, high-performing partnerships that benefit your organization and its plan participants. At PBM NEGOTIATOR™, we are committed to transforming your PBM contracts into powerful tools for cost control, compliance, and financial optimization.

Contact PBM NEGOTIATOR™ today to discover how our Guaranteed Value Creation service can optimize your PBM agreements and deliver lasting financial and operational benefits for your organization.

Strategic Contract Analysis

Legislative Compliance

Negotiation & Advocacy

Continuous Oversight

Fiduciary Risk Mitigation