Is Your Pharmacy "Benefit" Actually Beneficial?

As we close out 2025 and prepare for a new year, it's worth asking: When was the last time your pharmacy benefit manager (PBM) truly felt like a benefit to your organization?

For many employers and plan sponsors, the term "pharmacy benefit" has become something of a misnomer. What started as a service designed to reduce costs and improve healthcare outcomes has evolved into a complex system that often leaves clients wondering where the actual benefit went.

The Paradox of Today's Pharmacy Benefits

Consider these common scenarios:

Your Member Service representative puts you on hold for 30 minutes only to take a message and promise a callback "in a few days."

Your plan sees rising specialty medication costs year after year with little explanation.

Your PBM contract contains vague language about rebates, with only a percentage making its way back to you.

You're told your drug spend is "competitive" but have no visibility into actual costs.

These experiences raise an important question: Is what you're receiving from your PBM actually a benefit?

The Value Equation: Lower Costs, Better Service

At DisclosedRx, we believe a true pharmacy benefit should deliver exactly that: a benefit. This means providing genuine value through both cost savings and superior service.

What makes our approach different? We've built our model on a fundamental principle: you should pay less and get more.

The Five Pillars of a Genuine Pharmacy Benefit

A true pharmacy benefit should:

Strategically control costs while maximizing value for both the plan and its members.

Deliver Member Service that is not only responsive, but empathetic, solution-focused, and comprehensive.

Provide clear, real-time visibility into drug spend to empower smarter decision-making.

Ensure seamless alignment of plan and member goals with precise, accountable PBM execution.

Relentlessly pursue new and innovative pathways to unlock cost savings.

Full Disclosure means gaining clarity on the entire value equation, not just understanding the costs but fully recognizing the return on every dollar spent. Fiduciary Representation means acting with unwavering commitment to your goals, ensuring every decision is made in your best interest.

How We Deliver Real Benefits

Our Enhanced Specialty Cost Control and Agile Channel Management programs ensure that you never pay more than necessary while maintaining optimal access to essential therapeutics for your members.

Specialty medications can represent up to 45% of plan spend, even though only 1-2% of members take specialty drugs. Our specialty programs provide deep discounts for your plan, up to 75% per fill, while also reducing your members' copay spend. In many cases, the member's copay is zero while the plan saves up to 75%.

Our proprietary programs direct medications through the best channel before they hit your plan spend, delivering maximum savings to the client and optimal access for your members. By leveraging all available channels, we ensure that your plan never pays more than it needs to while still delivering the medications your members need. The right medication, for the right cost, at the right time, every time.

Is It Time to Rethink Your Pharmacy "Benefit"?

If your current pharmacy program feels more like an obligation than a benefit, it may be time to consider an alternative.

At DisclosedRx, we're disrupting the pharmacy benefits industry through truthfulness and innovation. Our clients come first, and our commitment to Fiduciary Representation and Full Disclosure ensures you always know exactly what you're getting and what you're paying.

As we head into 2026, consider what your pharmacy benefit could look like with a partner contractually and ethically bound to act in your best interests. A partner with 100% pass-through of all rebates and pricing, a single straightforward admin fee, and no shell games, ever.

Because a pharmacy benefit should actually be beneficial.

DisclosedRx: The Fiduciary and Fully Disclosed PBM®