WINDERMERE, Fla., March 15 ARMSRx (Administered Risk Management Services Rx, LLC), the health care industry's leader in transparent pharmacy benefits assessment, has received many requests for RFPs regarding pharmacy benefit and AWP neutrality reviews as the first quarter closes in 2010. The September 26, 2009 rollback of Average Wholesale Price (AWP) values by First DataBank (FDB) and Medispan may very well leave employers exposed to higher costs. ARMSRx represents TPAs, consulting firms, MCOs and many self-funded clients supporting their pharmacy benefit programs.
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While marketplace trend has held around 5%, most ARMSRx clients achieved a lower trend rate in 2009 while many groups maintained a negative trend. The new challenge in 2010 will be reviewing the neutrality of the AWP change. Clients want assurance their discounts are fair and equitable and the financial arrangement with their PBM is what was intended contractually.
Jennifer Kingsley Wilson; CEO of ARMSRx informs clients that "not all PBMs are created equal nor are their methodologies for AWP neutrality. While each PBM vendor takes a different approach, the understanding of their method of calculating new discount levels is not clearly understood by the payors. It is important that each client acquires their own unique AWP conversion rates and is not rolled into a combined aggregate conversion only to create more confusion and ambiguity."
While comparing post AWP and pre September 26, 2010 pricing changes, the evaluation resembles a short version of an audit. The process simply takes a snapshot of three months prior and post scenarios, making the exercise affordable for TPAs and employers to participate in.
ARMSRx employs a proprietary pricing and claim review system with standard and client defined reporting; making this highly complex information easy to understand.
ARMSRx is a pharmacy benefit consulting firm (not a pharmacy benefit manager) that specializes in saving payors money on their pharmacy expenditures. Most prescription benefit programs are based on financial arrangements that are complex, hidden and highly profitable to the Pharmacy Benefit Managers (PBMs). Our vested interest is the payors and our mission is to align the PBM's business objectives with the payors benefit goals. ARMSRx delivers intellectual capital. Contact Jennifer Kingsley Wilson at 407-909-8004 or email at [email protected]