Welcome.

• Drug costs are doubling every eight years.
• The Pharmacy Benefit Management (PBM) industry manages drug benefits for two-thirds of Americans. It has fostered the creation of an incredibly efficient claims processing system.
• At the same time, the PBM industry is under growing scrutiny for questionable business practices, including hidden rebates, murky pricing practices and formularies skewed to profit the PBM at the expense of the plan sponsor.
• Those with drug benefits are being compelled to pay a greater share.  As a result, some people may be foregoing the medicines they need to stay healthy.
• There is a growing awareness that some PBMs are doing a poor job on behalf of their clients. These PBMs will not accept fiscal responsibility for their services and audits of PBMs have resulted in major savings.
• There is a chronic shortage of pharmacists, while large drug chains continue to expand.
• Mail order pharmacy now accounts for twenty percent of retail drug sales, and is a major profit center for PBMs, but Mail Order savings may be more ephemeral than real.  In fact, some PBMs now offer 90-day retail programs that yield similar savings while preserving the relationship with the community pharmacy.
• Medicare recipients now have prescription drug coverage under Part D, but the program is off to a rocky start.
• While the large drug manufacturers have developed wonderful medicines that both prolong and improve the quality of life, their profits and returns on investment are well beyond business norms.
• Generic drugs are safe, effective and inexpensive.  Yet they are the source of huge, undisclosed profits for PBMs.

Winkelman Management Consulting (WMC) can help.

We have a broad range of expertise and experience in pharmacy benefit management, prescription benefit design, mail order pharmacy, PBM audits and the integration of pharmacy benefits and data into the health care mainstream.

Our consultants have helped a number of clients renegotiate their pharmacy benefit management, resulting in considerable, long term savings. We also help discover and analyze fraud and abuse.

 Our firm provides these services to governmental agencies, managed care organizations and commercial plan sponsors.

But our most important role is to help our clients understand and navigate through the complex pharmacy labyrinth.