Pharmacy Consulting Services
We combine contract integrity with clinical expertise, ensuring your members get the right medications, first and foremost, at the best price.
- Pharmacy Diagnostic to help understand what is currently driving pharmacy spend and how to manage it better.
- Pharmacy Directorship where Ethica becomes an extension of your HR team for year-long support.
Custom RFP Services
Our Custom RFP Services put transparency first, ensuring you control vendor selection and contract terms — not hidden alliances. While others push the same PBMs, we stay vendor-agnostic, delivering unbiased insights and real-time repricing analysis that digs deeper than industry norms.
Auditing Services
Verify accuracy. Resolve discrepancies. Maximize your savings.
- Discount Validation Audits analyze 100% of annual Rx claims to verify that PBMs apply the correct discounts and dispensing fees to ensure pricing aligns with contract terms.
- Rebate Contract Audits help validate the accuracy of Manufacturer Rebates on your plan design attributes
Implementation Support
We guide PBM transitions with oversight, contract negotiation, and weekly calls to ensure smooth membership transfer, accurate plan design, and correct coding. Our services also include pre-implementation audits and test claims to ensure seamless integration and accuracy, providing peace of mind throughout the process.
Analytics and Reporting
Our analytics service stands out with quarterly dashboards that track PBM contract performance, giving clients continuous insights into how their partner is performing against agreed terms. We provide ongoing reporting that goes beyond the standard annual review, ensuring you’re always informed and empowered.
Success Stories
Maximizing Savings
Ethica Drives 37% Reduction in Pharmacy Spend with Data-Driven Clinical Strategies Client: Large Employer Overview During a procurement process, Ethica negotiated significant savings by examining price point concessions across multiple PBMs. However, we took a deeper approach by analyzing the client’s actual drug mix. This allowed us to identify additional savings through clinical solutions, including […]
Expanding Specialty Pharmacy Access
Ethica Helps Large Employer Reduce Specialty Drug Costs by 4-10% Client: Large Employer Overview Ethica was engaged by a large employer to explore opportunities for reducing high specialty drug costs. The strategy focused on expanding access to a broader network of specialty pharmacies outside of an exclusive arrangement. Solution By introducing non-exclusive access to specialty […]
Driving Innovation in Rx Benefits
Ethica Helps Large Employer Achieve 20%+ Savings with Low Net Cost Medications Client: Financial Services Organization Overview A financial services organization was concerned that its current formulary favored highly rebateable brand-name drugs over clinically superior and lower-cost alternatives. This lack of optimization was driving up pharmacy costs without necessarily improving health outcomes for members. The […]
View All +
Insights
GLP-1s: Balancing Costs and Benefits
Obesity happens when your body stores too much fat, to the point where it can affect your health. It’s typically measured using BMI (body mass index), which is calculated by dividing your weight by the square of your height.
The Complexities Surrounding GLP-1 Agonist Drugs
The conversation around the cost and coverage of GLP-1 agonist (or GLP-1s) drugs for weight loss is one we frequently have with our clients.
News
Connie Perry Featured in BrokerTech Ventures
Ethica Pharmacy Advisors recently garnered attention in BrokerTech Ventures’ latest article, featuring insights from Connie Perry. She elaborated on how Ethica delivers transparent advice by meticulously reviewing Pharmacy Benefit Manager (PBM) contracts and harnessing technology to uncover significant savings.
Connie Perry Featured on In the Ring
Ethica Pharmacy Advisors’ Connie Perry joined Héctor Colón on the latest episode of In the Ring podcast.
Smart strategies tailored to your market
Our in-house experts understand your market and tailor strategies for your unique needs. Combine that with a cutting-edge technology engine that uncovers implications upfront and applied intelligence that delivers real-time insights and you have bespoke benefit solutions like no other.
Employers
Optimizing pharmacy spend is table stakes in our world. A benefits partner with true clinical acumen is something else entirely.
Payors & Providers
Our expert guidance helps your coalition navigate the complexities of the pharmacy benefits landscape with a focus on your success, not external interests.
Coalitions
Forget about conflicts of interest. At Ethica, we offer unbiased expertise to help coalitions navigate the complexities of the pharmacy benefits space.
Brokerages
You don’t have to hire a Pharm D to keep your brokerage lean and agile – not when you have Ethica.
Let’s make it make sense.
Pharmacy benefits clarity begins with our market analysis where we reveal data-driven insights and identify opportunities to help you make more informed decisions.