Your Innovative
Pharmacy Benefit
Expert

Get elite pharmacy benefit management through our PBM division, Transformation Rx. We deliver elite pharmacy savings with flexible and strategic pharmacy benefits.

integrated

01 WHAT YOU NEED

Clear PBM Contracts With Cost Containment Built In

Crumdale’s in-house pharmacy division and group purchasing coalition, Transformation Rx, offers custom and alternative Rx solutions that continuously control costs for clients. We deliver best-in-class PBM contracts and pricing with 100% transparency and advanced solutions for savings.

  • 1st-year pharmacy savings of ~15% – 33%
  • In-house PBM experts to negotiate best-in-class terms & pricing
  • Transparent prescription management & pricing

Proactive Management With Predictive Analytics

Our proactive pharmacy benefits management uses predictive analytics to provide trend and cost management. We also negotiate leading contracts to benefit any group size and help clients navigate the pharmacy ecosystem for improved clinical insight that delivers better health and financial solutions.

  • Transparency & expert insight into Rx spend drivers
  • Continuous high-cost claims management & high-cost drug support
  • Integrated PBM with alternative sourcing & PAP programs

02 HOW WE HELP

Customized, Competitive Pharmacy Benefits

Transformation Rx is an innovative pharmacy solutions provider for all constituents of the pharmacy supply chain. We offer consulting services, mid-market coalition contracts, alternative sourcing programs for specialty drugs and Rx-only stop-loss coverage. Our comprehensive PBM solutions continually cut costs for employer groups.

  • Over 30 Years of Experience
  • Innovative Specialty Rx Solutions
  • Alternative Sourcing
  • Plan Flexibility
  • Ongoing Support and Guidance

50%

PLAN SAVINGS
THROUGH ALTERNATIVE
SOURCING

20%

AVERAGE CONTRACT
SAVINGS

3M Lives

OVER 3,000,000
LIVES SERVICED

100%

CONTRACT
TRANSPARENCY

15% - 35%

FIRST-YEAR
SAVINGS

3%

GROWTH TREND
YEAR-OVER-YEAR

Built With Transparency for Brokers & TPAS

Our independent, transparent and vendor-agnostic approach ensures that clients are matched with solutions that create the most value while minimizing disruption. Our PBM solutions are built for the broker and TPA market to deliver customized and competitive solutions for:

  • RFP Consulting Services: Contract/Pricing Validation
  • Coalition-Level, Signature-Ready Contracts with Market-Leading Pricing
  • Specialty Drug Management
  • Alternative Sourcing Cost-Containment Solutions
  • Rx-Only Stop-Loss
  • Rebate Procurement

expertise

03 expertise

Specialized Areas of Focus & Expertise

To provide flexible and innovative solutions that meet clients’ unique needs, we have diverse expertise in a range of focus areas. Combined with our core PBM services, these additional areas of expertise allow us to customize plans, drive competitive pricing and increase contract coverage with advanced solutions for cost savings as needed.

Advanced PBM Solutions & Services

  • Pricing & Contract Procurement
  • Clinical Management
  • Contact Pricing Validation
  • Trend Management
  • Drug Pipeline Reporting
  • Peer Benchmarking
  • Specialty & Orphan Drug Management
  • Gene Therapy
  • Pharmacogenomics
  • Formulary Management
  • Cost Containment
  • MAC Management
  • PBM Vendor Management
  • White-Glove Account Management

components

04 COMPONENTS

Innovative Approach: Five Core Components

We deliver value to every client with advanced insight and expertise in various areas that combine with our core components to provide transparent, customized and flexible PBM solutions with market-leading pricing.

Our innovative and vendor-agnostic approach allows us to deliver exceptional pharmacy benefits solutions with a true hands-on management approach that ensures we match clients with the services they need.

  • RFP Services
  • Coalition Contracts
  • Specialty Drug Management
  • Stop-Loss Coverage
  • Data Analytics

Cost-Saving RFP Services

We make it easy to choose the pharmacy benefits services and solutions you want in your contract with expert RFP services and consulting. With industry expertise, we provide guidance to help create the perfect integrated proposal.

  • Contract Review
  • Contract Pricing Validation
  • Clinical Evaluation & Recommendations
  • Rebate Procurement

Clear & Competitive Coalition Contracts

We leverage our purchasing power to deliver coalition-level PBM contracts with 100% transparency. Each agreement is customized and optimized to provide value, ongoing savings, and clinical insight to improve performance.

  • Market-Leading Discounts & Rebates
  • 100% Transparency
  • Free of Optics & Games

Specialty Drug Management

We offer proactive pharmacy consulting with specialty drug management, alternative drug sourcing, and more to achieve the lowest Rx prices and reduce costs on otherwise expensive health-related treatments.

  • Alternative Funding Solutions
  • Strong Clinical Programs: (PA, UM, Step Therapy, QL, Split Fill)
  • Patient Engagement & Coaching
  • Copay Card/Accumulator Programs

Experienced Stop-Loss Coverage

With over 30 years of experience in PBM and stop-loss, we can help clients plan for and avoid high costs from prescription drugs. We’ll make sure plans provide protection and cost savings.

  • Competitive Rx-Only Stop-Loss Protection
  • Plan Design Recommendations
  • ERISA Consultation
  • Medical Channel Management

Expert Predictive Analytics Solutions

With predictive data analytics, we improve plan performance, measure KPIs and find clinical opportunities to identify and improve cost containment. We also offer trend management and forecasting.

  • Drug Class and Therapy Management
  • Predictive Modeling & Analytics
  • Retail Network and Formulary Disruption
  • High-Cost Drug and PA Reviews

components

05 Case studies

Controlling Costs at Renewal

Situation: Our broker partner had successfully built a block of business by transitioning clients to a self-funded platform; however, the group was having difficulty managing claims and started to experience significant increases in their medical stop-loss premium at renewal, making self-funding unstable for these groups.

Partnership: Crumdale Partners worked alongside the broker to understand the current suite of vendors serving the group of accounts to identify improvements that could be implemented.

Results: Franklin Health successfully stabilized costs, offered transparency and flexibility to the block, and significantly reduced spending over the next year through a market-leading PBM contract, Rx cost-containment solutions and active medical and Rx claims monitoring and management.

$1.7M +

Increased surplus retained from $0 to $1.7 million in one year

47%

Reduced claims spend by 47% over one year

$350k +

Saved more than $350,000 in claims through med & Rx intervention

$200k+

Annual Savings of $226,705

28.3%

1st-Year Savings

$350k +

Achieved $351,485 in Rebates

Advanced Clinical Insight

Situation: A pharmacy analysis was performed for a California employer receiving pharmacy benefits bundled through their medical carrier.​ The incumbent program lacked accountability with no contract guarantees, limited insight on Rx claim utilization and restricted payment validation.​

Partnership: Crumdale Partners worked alongside the broker to understand the current PBM solution and contract to provide a program with transparency and accountability.

Results: ​The newly proposed PBM program from TRx offered a signature-ready contract and proposal that would immediately yield significant savings based on current member utilization while improving the overall employer experience and resulting in minimal member disruption.​

results

Specialty Cost Containment
Case Studies

06 case results

Average Plan Savings: 61.1%*

CLIENT Plan cost without program PMPM Without program Plan Cost With program PMPM With program Savings ($) Savings (%) PMPM Savings ($)
#1:
238 Lives
$ 377,469 $ 132.17 $ 178,743 $ 62.58 $ 198,726 52.6% $ 69.58
#2:
237 Lives
$ 278,048 $ 97.77 $ 170,016 $ 59.78 $ 108,033 38.9% $ 37.99
#3:
46 Lives
$ 209,232 $ 379.04 $ 13,947 $ 25.27 $ 195,285 93.3% $ 353.78
* Based on average for the identified sample set. Actual results may vary.

Delivering Client Value:
Case Studies Across Industries

COMPANY Law Firm Tech Labor County City
LIVES 111 1,008 2,456 7,140 13,491
YEAR 1 SAVINGS ($) $ 10,555 $ 123,347 $ 352,621 $ 3,671,551 $ 5,145,422
YEAR 1 SAVINGS (%) 32.0% 20.7% 12.5% $ 3,671,551 24.1%

Continued Support
Even After Signing

Our relationship doesn’t need to end when the contract closes. Let our health insurance experts provide ongoing HR support, benefit navigation, and education services, so employees get the most out of their insurance and benefits.

09 how we care

contact

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but the way we tailor it to meet
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