Tuning Out the Noise: Top Strategies to Control Pharmacy Spend
It’s the same conversation at every quarterly check-in and renewal meeting. Your clients are asking why their pharmacy costs keep climbing. It’s a fair question, but in the world of health insurance, it seems like it’s just the reality we’re stuck in. And everyone is feeling the pain—and the pressure.
Traditional PBMs often operate like a black box, leaving brokers like you stuck trying to explain opaque pricing, minimal flexibility, and misaligned incentives.
At ClaimChoice, we believe brokers deserve more than that. In this edition of The Benefits Beat, we’re spotlighting five strategies you can use to help your clients reduce pharmacy spend and reclaim control.
1. Leverage the Power of Coalition-Based Pricing
One of the most effective ways to reduce pharmacy costs is to move away from fragmented, standalone pricing structures. Coalition-based pharmacy models unite employer groups under a shared purchasing structure to maximize negotiating power and pass along real savings.
You gain:
✔️ Transparent, pass-through pricing
✔️ Collective volume leverage
✔️ A stronger negotiating position for your clients
It’s the kind of strategy that delivers savings and builds trust with your groups.
2. Bring Strategic Consulting Into the Conversation
You’ve known it for a while now, off-the-shelf just doesn’t cut it anymore. Forward-thinking brokers are partnering with pharmacy solutions that embed third-party consultants and advisory expertise to work with you to design smarter plans.
This approach means you’re co-architecting benefit designs that are aligned with client goals, workforce needs, and utilization trends. It’s how brokers step into an elevated advisor role and lead the pharmacy conversation.
3. Promote Evidence-Based Clinical Programs That Drive Value
Your clients expect Rx programs that actually work, not just ones that sound good in a pitch. Look for partners whose clinical programs are powered by an independent, proven clinical structure with a track record of lowering costs and improving member outcomes.
It’s a meaningful way to:
- Reduce unnecessary spend
- Support population health
- Back up your recommendations with data
4. Demand Full Transparency and Real-Time Data Access
If your client doesn’t know what they’re spending, what they’re spending it on, and can’t access their own data in real time, they can’t manage their plan effectively. Brokers should expect pharmacy solutions to deliver full claims visibility and easy-to-understand performance dashboards.
This level of transparency allows you to:
- Identify cost drivers
- Validate savings
- Have more strategic client conversations
In other words, less guesswork and more guidance.
5. Focus on Long-Term Plan Integrity
Quick wins may sound great, but sustainable savings require a solid structural foundation. Pharmacy benefit strategies should be built for long-term stability, with aligned incentives and scalable programs that flex with your clients’ needs.
For brokers, this means fewer service issues, better client retention, and plans that perform consistently, with no surprise remixes.
Remix Your Pharmacy Benefits Strategy
Helping your clients cut pharmacy spend shouldn’t feel like an impossible task. At ClaimChoice, Your Benefits Studio, we work with industry-leading partners who deliver the transparency, strategy, and control brokers need.
Ready to bring a better Rx solution to your book of business?
Let’s talk. We’ll help you hit the right note.