Pharmacy Benefit Managers (PBMs), while intended to help manage pharmacy programs, often contribute to rising pharmacy costs through opaque business practices. Their vague contract terms can obscure the actual value of discounts and rebates, making it difficult for employers to verify actual savings.

TheChallenge with PBMs

PBM contracts are notoriously complex, and ambiguous language around "discounts" and "rebates" can mask underperformance.For example, a "discount" might depend on how a drug is dispensed or how a "brand drug" is defined. Similarly, a "rebate" might exclude certain claims, such as vaccinations. Without a clear analysis of these terms, employers may unknowingly lose significant savings.

TheSolution: RxCognition

To address these challenges, we developed RxCognition, an AI-powered claims and PBM analytics platform. RxCognition enhances transparency and uncovers insights that can be used to make data-driven decisions that optimize pharmacy benefits.

RxCognition simplifies the evaluation of PBM performance by:

• Mapping Discount Structures: Modeling how Average Wholesale Price (AWP) discounts are set by channel.
• Dissecting Rebate Formulas: Identifying which drugs qualify for rebates and calculating expected savings.
• Leveraging Real-Time Analytics: Comparing claims against contract terms to instantly     identify discrepancies.

By decoding complex agreements and benchmarking performance, RxCognition gives an unbiased view of pharmacy benefits, ensuring that you receive what is promised.

Why It Matters

With RxCognition, employers can hold PBMs accountable, maximize plan savings, and make informed decisions about their pharmacy benefits. Our platform shines a light on discount and rebate guarantees, helping employers unlock hidden savings and improve their bottom line.

Take the Next Step

Ready to take control of your pharmacy benefits? Learn more about RxCognition and schedule a demo at www.mydrugcosts.com/rxcognition.