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- 17/02/26
Preparing for PBM Transparency Mandates: What Employers Must Know About New Federal Compliance Rules
Recent legislative and regulatory updates are shaping new PBM transparency and disclosure requirements, and Ethica Pharmacy Advisors is here to outline the compliance considerations for employers. On January 30, 2026, the Department of Labor (DOL) released proposed rules (“Improving Transparency into Pharmacy Benefit Manager Fee Disclosure”) developed pursuant to Executive Order 14273 and supported under […]
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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 […]
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Insights
Why an Independent Consultant Changes the Value of a PBM Audit
Changing the conversation with the PBM Audits typically come with a heightened sense of anxiety and pressure for PBMs. When an independent consultant with no other PBM interests or alliances is involved, PBMs can be more certain the reporting is fair and credible. That dynamic can lead to more constructive conversations during data requests, dispute resolution, […]
Ethica Auditing Services: From Spreadsheets to Digital
Ethica’s PBM audit services Ethica’s digital-first approach supports a range of PBM audit services designed to validate contractual performance, uncover financial risk, and strengthen plan oversight, including: How the audit process works The exact audit timeline varies based on the audited organization and type of audit. Audited organizations frequently specify allowable response times in their […]
Medicare Part D Creditable Coverage: FSA, HRA and ICHRA Disclosures & 2027 Simplified Determination Method
On April 6, 2026, the Centers for Medicare & Medicaid Services (CMS) released final rules regarding Medicare Part D creditable coverage disclosures and determinations. Specifically, CMS eliminated the requirement for account-based plans, including Individual Coverage Health Reimbursement Arrangements (ICHRAs), to provide creditable coverage disclosures and finalized changes to the simplified method for determining a plan’s […]
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News
Preparing for PBM Transparency Mandates: What Employers Must Know About New Federal Compliance Rules
Recent legislative and regulatory updates are shaping new PBM transparency and disclosure requirements, and Ethica Pharmacy Advisors is here to outline the compliance considerations for employers. On January 30, 2026, the Department of Labor (DOL) released proposed rules (“Improving Transparency into Pharmacy Benefit Manager Fee Disclosure”) developed pursuant to Executive Order 14273 and supported under […]
Strategic Risk or Missed Opportunity? Rethinking Obesity in Employer Health Plans
Rethink obesity care in employer health plans. Hear from experts on coverage, cost, and how to support your workforce.
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.
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Strategic Risk or Missed Opportunity? Rethinking Obesity in Employer Health Plans
Rethink obesity care in employer health plans. Hear from experts on coverage, cost, and how to support your workforce.
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