Stop overpaying for prescription drugs.
Pharmacy spend is now the fastest-growing cost in your benefits program — and most employers have no idea what they're actually paying or why. Your Policy gives you independent pharmacy benefits consulting to take back control.
Avg. annual per-employee pharmacy spend
Typical employer overpayment on Rx
Fastest-growing benefits cost category
US prescription drug spend annually — growing at 8% per year
Of employer pharmacy contracts contain hidden PBM spread pricing
In rebates most employers receive — despite billions generated annually
Rate at which specialty drug costs are rising relative to traditional drugs
Your PBM is working for the supply chain — not for you.
Pharmacy Benefit Managers (PBMs) process prescription claims between your plan and the pharmacy. What most employers don't realize is that the largest PBMs — CVS Caremark, Express Scripts, and OptumRx — own or are owned by insurance companies, specialty pharmacies, and mail-order operations.
That means the company managing your drug benefit has a financial incentive to steer your employees toward higher-cost drugs, retain manufacturer rebates, and charge spread pricing — the difference between what they pay the pharmacy and what they charge your plan.
Independent pharmacy benefits consulting means you have an advisor who works for you, not the supply chain — auditing your current contract, identifying overpayment, and negotiating terms that put cost savings back in your plan.
Independent analysis. Transparent pricing. Real savings.
Your Policy works with independent pharmacy benefit platforms and pass-through PBM partners to give employers complete visibility into their pharmacy spend — and the tools to reduce it.
Our partners give employers real-time access to their pharmacy claims data, formulary performance, and PBM contract terms — so nothing is hidden. We operate exclusively on a pass-through pricing model, meaning 100% of manufacturer rebates flow back to the employer and there is no spread pricing.
Together, our platforms and independent consulting give employers what they've never had before: a pharmacy benefit that works for them.
Claims Transparency Platform
Employer pharmacy intelligence platform
Real-time claims transparency, formulary management, clinical programs, and employer reporting — giving you complete visibility into every pharmacy dollar.
Pass-Through PBM
Pass-through PBM platform
100% of rebates returned to the employer. Zero spread pricing. Ingredient cost plus dispensing fee — you pay exactly what the pharmacy gets paid, nothing more.
Pharmacy consulting services
A complete approach to reducing pharmacy spend without reducing employee benefits.
PBM Contract Audit
We review your current PBM contract line by line — identifying spread pricing provisions, rebate retention clauses, formulary restrictions, and performance guarantees that aren't being met. Most audits identify six-figure overpayments in the first year.
Pass-Through Pricing
We move employers to a pass-through model — ingredient cost plus dispensing fee, full rebate pass-through, and zero spread pricing. Employers typically save 15–30% on pharmacy spend in year one.
Formulary Optimization
An optimized formulary steers members toward clinically equivalent, lower-cost alternatives — generics, biosimilars, and preferred brands. We design and manage formularies that reduce cost without sacrificing clinical quality or employee satisfaction.
Specialty Drug Management
Specialty drugs represent less than 2% of prescriptions but 50%+ of pharmacy spend. We apply clinical authorization protocols, specialty pharmacy network management, and copay optimization to control this rapidly growing cost category.
Claims Analytics & Reporting
Our claims analytics platform gives employers real-time access to claims data, utilization patterns, formulary performance, and cost drivers — so decisions are data-driven, not guesswork. Monthly reporting with actionable insights included.
Employee Education & Engagement
The best pharmacy benefit doesn't work if employees don't use it correctly. We provide member communications, formulary education, and pharmacy navigation support to maximize utilization of lower-cost options.
PBM RFP & Competitive Bidding
When it's time to go to market, we manage the full PBM request-for-proposal process — developing specs, evaluating bids, and negotiating contracts on your behalf. We know what benchmarks look like and we hold vendors to them.
Clinical Program Management
Drug management programs, step therapy protocols, prior authorization management, and adherence programs — designed to improve clinical outcomes and reduce the cost of poorly managed chronic conditions.
Ongoing Plan Monitoring
Pharmacy costs don't stand still. We monitor your plan quarterly — tracking PBM performance against guarantees, identifying new cost drivers, and adjusting strategy as the drug market evolves.
How we get started
From initial claims review to measurable savings — here's what the process looks like.
Claims Data Review
We request 12 months of pharmacy claims data from your current PBM. No cost, no commitment. Within two weeks we'll show you exactly what's in your data.
Contract Audit
We review your PBM contract against your actual claims — identifying spread pricing, retained rebates, and contract guarantees that aren't being honored.
Savings Analysis
We model the financial impact of moving to transparent pricing, formulary optimization, and specialty drug management — with real numbers, not projections.
Implementation & Monitoring
We manage the transition, communicate with employees, and monitor performance monthly — holding your PBM accountable to the terms we negotiated.
Common questions
Everything employers ask before moving to an independent pharmacy benefit consultant.
Spread pricing is the difference between what a PBM pays the pharmacy for a drug and what it charges your plan. If a PBM pays a pharmacy $10 for a generic and charges your plan $25, the $15 difference is spread — and it goes into the PBM's pocket, not back to you. Most traditional PBM contracts allow this practice and most employers have no visibility into it. A pass-through model eliminates spread entirely.
Drug manufacturers pay rebates to PBMs in exchange for preferred placement on the formulary. These rebates are significant — often hundreds of dollars per prescription on brand drugs. Traditional PBM contracts allow the PBM to retain most or all of these rebates. In a transparent, pass-through model, 100% of rebates go back to the employer plan. Over the course of a year, this can represent hundreds of thousands of dollars for mid-size employers.
It depends on your current contract, employee population, and drug mix — but employers who move from a traditional PBM to a transparent model typically save 15–30% on total pharmacy spend in the first year. For a 200-employee company spending $400,000 annually on pharmacy, that's $60,000–$120,000 in recovered costs. We model this specifically for your plan before you make any changes — so you see the numbers before committing.
Transitions are managed carefully to minimize disruption. Most employees can keep their pharmacy and their prescriptions without interruption — a transition typically involves updating their pharmacy card and, for employees on specialty drugs, a brief transition coordination period. We manage member communications throughout and provide a dedicated support line during the transition window.
No. The pharmacy benefit and the medical benefit are separate. You can carve out the pharmacy benefit from your current medical carrier and move it to an independent PBM without changing your medical plan, network, or carrier. This is called a pharmacy carve-out and it's a standard practice — particularly for self-funded employers.
Self-funded employers have the most flexibility to make pharmacy benefit changes — and typically see the largest savings because they're directly exposed to the cost. Fully-insured employers have fewer options since the pharmacy benefit is typically bundled with the medical contract, but we can still audit your current arrangement and advise on what's possible at renewal.
See what your pharmacy benefit is actually costing you.
A pharmacy claims review costs nothing and takes two weeks. Most employers find six figures in savings they didn't know existed. Schedule yours today.