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TransparentRx Under TransparentRx's fiduciary model, contracts negotiated between clients and pharmacies are designed to be as transparent as possible.

TransparentRx is a fiduciary pharmacy benefits administrator helping employers cut drug costs, remove conflicts of interest, and protect plan assets through radical transparency, accountability, and a fiduciary standard of care.

Chasing PBM rebates might look like a win on a spreadsheet, but it’s often our employees who end up footing the bill at ...
10/13/2026

Chasing PBM rebates might look like a win on a spreadsheet, but it’s often our employees who end up footing the bill at the pharmacy counter.

When it comes to biosimilars, a high rebate drug usually masks an inflated list price. If we want to offer truly competitive benefits, we need to stop optimizing for rebates and start prioritizing the lowest POS cost. That’s how we ensure healthcare savings actually reach the patient.

Great perspective from TransparentRx on why true value in pharmacy benefits means protecting both the company's bottom line and our people's wallets.

Read the full breakdown here 👇.

Among clinically appropriate options we look for the most cost effective drug therapy to avoid the hidden cost of biosimilar rebates.

A pharmacy benefits strategy needs attention long after the contract is signed.For brokers and employers, a simple month...
10/06/2026

A pharmacy benefits strategy needs attention long after the contract is signed.

For brokers and employers, a simple monthly check can make a big difference: Are costs tracking as expected? What’s changed? What needs action?

Quarterly reviews still matter, but surprises shouldn’t wait until then. The sooner you spot a problem, the more time you have to do something about it.

Read the article 👇.

Continuous monitoring in pharmacy benefits management is an active, deliberate and urgent accountability process.

The real risk in pharmacy benefits procurement isn’t a lack of data. It’s assuming the platform has captured everything ...
09/05/2026

The real risk in pharmacy benefits procurement isn’t a lack of data. It’s assuming the platform has captured everything that matters.

Technology can improve speed and consistency, but meaningful oversight still requires experienced judgment around contract terms, assumptions, and what ultimately drives plan performance.

The opportunity is to use these tools to sharpen decision-making, not outsource it.

Pharmacy benefits procurement and oversight platforms promise to simplify a difficult job but their efficiency can create a false sense of certainty.

https://transparentrx.com/the-pbm-kickback-ban-employers-and-brokers-should-be-watchingThe PBM Kickback Prohibition Act ...
08/13/2026

https://transparentrx.com/the-pbm-kickback-ban-employers-and-brokers-should-be-watching

The PBM Kickback Prohibition Act could force a long overdue question into the open. Is your broker recommending the best PBM for your plan or the PBM paying them the most?

Employers deserve advice they can trust. Brokers who already operate with transparency should welcome the scrutiny. That is what a fiduciary standard of care should look like.

A proposed PBM kickback ban could reshape how employers buy pharmacy benefits.

Most pharmacy benefit conversations center on rebates, discounts, formularies, and guarantees. All of those are importan...
06/25/2026

Most pharmacy benefit conversations center on rebates, discounts, formularies, and guarantees. All of those are important, but they do not explain how clinical coverage decisions are made.

Medication policies do. They spell out when a drug may be covered, what documentation is needed, which therapies should be tried first, what quantity limits apply, and when continued use should be reviewed.

For employers, this is not just about managing drug spend. Clear medication policies help explain the “why” behind coverage decisions, especially when an employee disagrees with the outcome.

For brokers, consultants, and Benefits Directors, these policies are worth a closer look. They are part of responsible plan oversight and should support a fiduciary standard of care.

Good medication policies help drive decisions that are consistent, defensible, and aligned with the plan sponsor’s intent.

A pharmacy savings strategy can look good on paper and still fail in the claims data.One of the easiest places to see it...
06/18/2026

A pharmacy savings strategy can look good on paper and still fail in the claims data.

One of the easiest places to see it is non-formulary spend. The benchmark is called the Formulary Compliance Rate:

Non-formulary drug spend ÷ total net drug spend × 100

If paid non-formulary spend is running above 3%, that should trigger a deeper review of exception approvals, therapeutic classes, reason codes, and whether the P&T committee’s work is being bypassed.

This is not about denying care. Good formulary management still allows fair, clinically appropriate exceptions.

But “access” should not become a shield for poor oversight, rebate-driven decisions, or special handling that undermines the plan’s clinical and financial intent.

A fiduciary standard of care requires employers to know whether the formulary is actually being followed, whether exceptions are documented, and whether coverage decisions are being made in the plan’s best interest.

If members are routinely filling non-formulary drugs, this is a clear signal why your healthcare savings strategy is failing.

PBM decisions are easier when HR starts with the right question.Not, “How big is the discount?”Not, “How strong is the g...
06/08/2026

PBM decisions are easier when HR starts with the right question.

Not, “How big is the discount?”
Not, “How strong is the guarantee?”
Not, “How polished is the proposal?”

The better question is:

Can we prove this arrangement puts the employer’s interests first?

That one question changes the review process. It shifts attention from surface-level pricing to contract terms, revenue streams, claims data, audit rights, and conflicts of interest.

For self-funded employers, pharmacy benefits are not just a purchasing decision. They are a fiduciary decision. A clear decision tree helps HR separate what sounds good from what actually protects the plan.

Self-funded employers face a difficult tradeoff in pharmacy benefit management. A HR Decision Tree helps in the decision-making process.

Clinical rigor is one of the most important, and often overlooked, parts of pharmacy benefit management. For benefit dir...
05/25/2026

Clinical rigor is one of the most important, and often overlooked, parts of pharmacy benefit management. For benefit directors, CFOs, brokers, and consultants, the goal is not just to lower pharmacy costs. The goal is to make sure every clinical and financial decision can be explained, documented, and defended.

That starts with a few basic questions:

→ Is the formulary built by a conflict-free P&T committee?
→ Are prior authorization and step therapy rules clinically appropriate?
→ Are exceptions reviewed consistently?
→ Is non-formulary spend being monitored?
→ Are high-cost drugs being evaluated based on net cost, safety, efficacy, and patient impact?

A clinically rigorous pharmacy benefit does not restrict care. It creates a fair process for determining which drugs should be covered, when exceptions are appropriate, and how the plan can protect both member access and plan assets.

This matters because pharmacy benefit decisions should not be driven by rebates, spread pricing, or hidden financial incentives. They should be driven by evidence, transparency, and a fiduciary standard of care.

When clinical rigor is built into the pharmacy benefit, plan sponsors are in a better position to reduce waste, improve oversight, and support better outcomes for members. That is the standard more self-funded employers should expect.

The essential elements of clinical rigor in pharmacy benefits means a pharmacy claim can look clean and still be wrong.

Transparency in pharmacy benefits sounds good, but it means very little if it is not backed by contract authority.In thi...
05/09/2026

Transparency in pharmacy benefits sounds good, but it means very little if it is not backed by contract authority.

In this post, I asked ChatGPT to score our PBA services agreement for employer control and transparency. The lesson was not the score. The lesson was what changed when fiduciary language, audit rights, rebate ownership, and plan sponsor authority were weakened.

Self-funded employers should ask one practical question:

Does your PBM agreement give you enforceable control, or are you relying on vendor promises?

Read the audit clause. Review rebate ownership. Confirm who controls the formulary, specialty arrangements, network strategy, data access, and plan economics.

That is where fiduciary oversight starts.

I recently asked ChatGPT to score our pharmacy benefit administrator (PBA) services agreement based on control and transparency.

Address

10845 Griffith Peak Drive, Suite 200
Las Vegas, NV
89135

Opening Hours

Monday 9am - 8pm
Tuesday 9am - 8pm
Wednesday 9am - 8pm
Thursday 9am - 8pm
Friday 9am - 8pm

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+18664991940

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