Pharmacy Benefit Management2024-03-15T16:05:28+00:00

Pharmacy benefit Solutions

Customized & Competitive

pharmacy benefit management

Crumdale Partners is an innovative pharmacy solutions provider for all constituents of the pharmacy supply chain.

Our Pharmacy Offerings

Our in-house pharmacy division and group purchasing coalition offers custom and specialty Rx solutions that continuously control costs for clients. Our independent, transparent, and vendor-agnostic approach ensures that clients are matched with solutions that create the most value while minimizing disruption.

  • Coalition-Level, Signature-Ready Contracts with Market-Leading Pricing
  • Self-Funded & Level Funded Health Plans
  • Specialty Drug Management
  • Rx-Only Stop-Loss Coverage
  • RFP Consulting Services: Contract/Pricing Validation
  • Rebate Procurement
  • Prescription Discount Cards
  • Medical Channel Management
  • Ongoing Clinical Support & Guidance

  • Vendor Relations Management
  • Independent Reconciliation & Auditing

Built With Transparency for Brokers & TPAS

0M
Pharmacy Dollars Under Management
0
PMPM (per member per month) plan spend
0+
Clients
0%
25-50% Average First-Year Savings
0%
Plan Savings through Specialty Solutions
0%
Plan Cost PMPM Annual Trend

Questions about OUr innovative insurance solutions?

Our Innovative Approach: Five Core Components

We deliver value to every client with advanced insight and expertise in various areas that combine with our core components to provide transparent, customized, and flexible PBM solutions with market-leading pricing. Our innovative and vendor-agnostic approach allows us to deliver exceptional pharmacy benefits solutions with a true hands-on management approach that ensures we match clients with the services they need.

  • Cost Saving RFP Services
  • Clear & Competitive Coalition Contracts
  • Specialty Drug Management
  • Experienced Stop-Loss Coverage
  • Expert Predictive Analytics

Cost Saving RFP Services

We make it easy to choose the pharmacy benefits services and solutions you want in your contract with expert RFP services and consulting. With industry expertise, we provide guidance to help create the perfect integrated proposal.

  • Contract Review
  • Contract Pricing Validation
  • Clinical Evaluation & Recommendations
  • Rebate Procurement

Clear & Competitive Coalition Contracts 

We leverage our purchasing power to deliver best-in-class PBM contracts and pricing with 100% transparency and advanced solutions for savings. Each agreement is customized and optimized to provide value, ongoing savings, and clinical insight to improve performance. 

  • Fortune 50-Level Discounts & Rebates 
  • In-house PBM experts to negotiate best-in-class terms & pricing 
  • 25-50% Average First-Year Savings 
  • Transparent prescription management & pricing 

Specialty Drug Management

We offer proactive pharmacy consulting with specialty drug management to achieve the lowest Rx prices and reduce costs on otherwise expensive health-related treatments.

  • Strong Clinical Programs (PA, UM, Step Therapy, QL, Split Fill)
  • Patient Engagement & Coaching
  • Copay Card/Accumulator Programs

Experienced Stop-Loss Coverage

With over 30 years of experience in PBM and stop-loss, we can help clients plan for and avoid high costs from prescription drugs. We’ll make sure plans provide protection and cost savings.

  • Competitive Rx-Only Stop-Loss Protection
  • Plan Design Recommendations
  • ERISA Consultation
  • Medical Channel Management

Expert Predictive Analytics

Our proactive pharmacy benefits management uses predictive analytics to improve plan performance, measure KPIs, and find clinical opportunities to identify and improve cost containment. We also offer trend management and forecasting.

  • Transparency & expert insight into Rx spend drivers
  • Continuous high-cost claims management
  • Drug class & therapy management
  • Retail network & formulary disruption management
  • High-cost drug and PA reviews

Our Value Proposition

When you join the Crumdale Partners network you gain leverage to reduce employee benefits costs, plus exclusive access to:

  • Turnkey, transparent solutions that are easy to understand
  • Industry subject matter expertise and local market knowledge
  • Creative cost containment strategies
  • Superior contracts
  • Best-in-class vendor and carrier relationships
  • Alternative risk financing and management
  • Expert data analysis, actuarial and compliance support
  • Agile solutions tailored to meet your needs

Specialized Areas of Focus & Expertise  

To provide flexible and innovative solutions that meet clients’ unique needs, we have diverse expertise in a range of focus areas. Combined with our core PBM services, these additional areas of expertise allow us to customize plans, drive competitive pricing and increase contract coverage with advanced solutions for cost savings as needed. 

Advanced PBM Solutions & Services 

  • Pricing & Contract Procurement
  • Clinical Management
  • Contact Pricing Validation
  • Trend Management
  • Drug Pipeline Reporting
  • Peer Benchmarking
  • Specialty & Orphan Drug Management
  • Gene Therapy
  • Pharmacogenomics
  • Formulary Management
  • Cost Containment
  • MAC Management
  • PBM Vendor Management
  • White-Glove Account Management

SUCCESS STORIES

Controlling Costs at Renewal

Advanced Clinical Insight

Specialty Cost Containment Case Studies

AVERAGE PLAN SAVINGS: 61.1%*
CLIENT Plan Cost without Program PMPM without Program Plan Cost with Program PMPM with Program Savings ($) Savings (%) PMPM Savings ($)
#1:
238 Lives
$ 377,469 $ 132.17 $ 178,743 $ 62.58 $ 198,726 52.6% $ 69.58
#2:
237 Lives
$ 278,048 $ 97.77 $ 170,016 $ 59.78 $ 108,033 38.9% $ 37.99
#3:
46 Lives
$ 209,232 $ 379.04 $ 13,947 $ 25.27 $ 195,285 93.3% $ 353.78

* Based on average for the identified sample set. Actual results may vary.

Delivering Client Value: Case Studies Across Industries

COMPANY Law Firm Tech Labor County City
LIVES 111 1,008 2,456 7,140 13,491
YEAR 1 SAVINGS ($) $ 10,555 $ 123,347 $ 352,621 $ 3,671,551 $ 5,145,422
YEAR 1 SAVINGS (%) 32.0% 20.7% 12.5% 36.0% 24.1%

Let’s work together

INSURANCE ISN’T NEW, BUT THE WAY WE TAILOR IT TO MEET YOUR NEEDS IS.

CONTACT US TODAY FOR A COMPLIMENTARY, CONFIDENTIAL CLIENT ASSESSMENT.

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