Pharmacy Services

We assist organizations through the development of their go-forward strategy as they navigate potential regulatory and competitive disruption in the pharmacy-services industry.

We guide the design and implementation of pharmacy-services solutions across a range of levers, including lean optimization, demand management (for example, streamlining a prior-authorization list), digital automation (such as building intelligent web intake and technology-enabled reviews), and improved organizational culture and processes.

We help organizations better manage their pharmacy spend through a combination of predictive analytics, proprietary data sets, and implementation expertise (from contracting to process design).

A state was seeing rising costs of its Medicaid program, especially in pharmacy spend. We developed several initiatives, including traditional utilization-management levers, a rebate-capture strategy, and novel contracting, to save the state 3–5 percent of its total pharmacy spend.

A health system was looking to optimize its supply chain as part of becoming more financially sustainable. We helped improve its performance in pharmacy services through formulary management, inventory enhancement, and contracting techniques to save approximately $10 million (around 3 percent) per year in its supply chain.

We helped revamp an organization’s pharmacy contracting, including end-to-end contract renegotiation for its pharmacy benefit manager, narrowing of formularies, and selection of the most appropriate formularies across all segments of the business (commercial, Medicaid, and Medicare). This created a total savings of more than 7 percent of pharmacy cost during the program’s first 12 months.

We designed the detailed clean-sheet future state processes and IT solutions needed to transform rebate processing, identified $100M+ in run rate impact through automation, increased accuracy, accountability and visibility. Developed a detailed list of 30+ initiatives to enable single source of truth/operational data store, automate workflow engine and enable POS rebates and monthly billing for pharmaceutical companies.

Supported pharmaceutical wholesaler in transforming its customer facing operations to unlock over $300M in value through more nuanced, analytically driven customer segmentation and the development of comprehensive value propositions tailored to the unique needs of induvial customer segments. Redesigned internal organization and operating model to better support field activities and streamline internal bureaucracy and redundancy.

Conducted in-depth analysis of market dynamics – population density, condition density, health plan penetration and membership dynamics, PBM affiliation, network constructs, etc. – in order to identify and prioritize growth opportunities for leading retail pharmacy. Able to identify market-level strategies to drive growth and differentiate in-store offerings relative to competitors, based on the unique needs of the local populations and regional health plans.