Key Takeaways A drug formulary is an approved list of prescription medications covered under a health plan. It guides prescribers toward safe, effective, and affordable medication options. Developed by medical experts, formularies are grounded in clinical research and cost-effectiveness. Many organizations rely on pharmacy benefit managers (PBMs) to design and manage formularies as part of…

Key Takeaways  What Is a PBM and Why Employers Rely on Them A pharmacy benefit manager (PBM) administers prescription drug benefits on behalf of employers, health plans, and other plan sponsors. PBMs negotiate drug prices, manage formularies, process claims, and coordinate pharmacy networks to balance cost savings with access to care.  For employers, effective management of prescription…

Even as national satisfaction levels decline and plan sponsors report their lowest confidence in PBMs in a decade, our 2025 Client Satisfaction Survey highlights how our flexible model, client-centricity, and commitment to saying yes create a meaningful competitive advantage. 

In 2025, our clients spoke clearly. They’re satisfied, they trust our teams, and they value our expertise. And in a PBM landscape where national satisfaction has sunk to decade-long lows, our strong performance stands out even more.

The FDA’s recently released draft guidance could make it easier and faster for biosimilar medications to reach the market – and our clients are already ahead of the curve.  What the FDA is Proposing On October 29, the FDA announced significant reforms to streamline biosimilar development.1,2 The proposed changes would reduce the requirement for costly, time-consuming comparative efficacy studies…

With our  Amazon Pharmacy partnership, managing prescriptions is easy. The platform offers competitive pricing and potential savings. Amazon’s integration with insurance plans streamlines the process for members. This transparency helps clients understand costs upfront.  The service is designed to reduce complexity for both clients and providers. It leverages Amazon’s logistics network for timely medication delivery.  Amazon Pharmacy’s innovative approach addresses common industry pain points. It offers a…

This quarter brought significant developments across federal policy, state legislation, and the courts—each with potential implications for the health plans you manage. From new drug pricing agreements and innovative purchasing platforms to sweeping state PBM reforms and ongoing legal battles over ERISA preemption, understanding these changes will help you anticipate questions, address concerns, and position your clients for success.

Understanding the difference between pharmacy and medical benefits is essential for ensuring that clients understand how plan sponsors structure and manage  health  care plans. These two components of health insurance are designed to address different aspects of healthcare needs, and recognizing their unique features can significantly enhance the way benefits are structured and delivered. Defining…

Specialty drug management is crucial for achieving optimal healthcare outcomes. These high-cost medications require precision in their administration. Effective management results in better patient outcomes and cost savings, so key stakeholders must coordinate efforts for better efficiency.

Investing in robust management strategies supports healthcare innovation. It fosters collaboration among providers, payors, and pharmacies. Tailored management approaches optimize treatment and encourage personalized care. By focusing on these aspects, we ensure the sustainability of specialty drug use and its role in modern medicine.

harmacy benefit compliance is evolving rapidly. New state laws are reshaping reimbursement models, while federal updates on creditable coverage, transparency, and technical standards—along with recent court rulings testing ERISA preemption—are redefining how pharmacy benefits are managed. In this session, Serve You Rx’s compliance team unpacks the latest regulatory trends driving change across the industry, from state-level spread pricing bans, NADAC-based reimbursement, and new PBM requirements to federal shifts in Medicare Part D rules, disclosure mandates, transparency file obligations, and upcoming technical deadlines. The discussion also explores key litigation developments influencing how far state laws can reach into self-funded plans.

Navigating the complex world of pharmacy benefits can be daunting. This is where a pharmacy benefits manager (PBM) steps in. PBMs are essential partners in managing prescription drug benefits efficiently.  They negotiate with drug manufacturers and pharmacies to secure cost savings. This results in reduced medication costs for both employers and patients. PBMs streamline the…