Why an Independent Consultant Changes the Value of a PBM Audit

A more tailored PBM audit scope

As an independent consulting firm, Ethica listens to its clients to understand their needs and assesses audits around what is heard versus what is standard and off the shelf. That means the audit scope is built around what matters most to the client, not a one-size-fits-all framework. This approach helps ensure the findings are relevant, practical, and aligned with the client’s priorities.

“At Ethica, we have no aligned incentives. Our priority is the client.” –Joy Schleusner, Director of Pharmacy Operations

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, and recovery negotiations.

Removing conflicting priorities

PBM-aligned auditors may act in the best interest of the PBM. At Ethica, we have no aligned incentives. Our priority is the client. We do not share information in ways that create competing interests or compromise the client’s trust. This independence helps keep the audit focused on accuracy, transparency, and meaningful outcomes.

Recommendations clients can trust

There is no financial skin in the game for an independent consultant. Fairness, credibility, and reputation are important to us. That drives our ability to put the client first and deliver an unbiased audit. As a result, clients have greater confidence in findings and recommendations that are not tied to other business interests or ongoing revenue.

Support beyond the final report

Once the report is delivered, if there are financial findings, we remain engaged with the PBM through final payment. The findings are often complex and may require further explanation. We participate in meetings to ensure relevant client stakeholders understand the information, potential next steps, and recommendations. This reflects how independent consultants approach PBM audits as an ongoing process—supporting follow-through until items are resolved.