Your Innovative
Pharmacy Benefit
Expert
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%
THROUGH ALTERNATIVE
SOURCING
20%
SAVINGS
3M Lives
LIVES SERVICED
100%
TRANSPARENCY
15% - 35%
SAVINGS
3%
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
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
- Contract Review
- Contract Pricing Validation
- Clinical Evaluation & Recommendations
- Rebate Procurement
Clear & Competitive Coalition Contracts
- Market-Leading Discounts & Rebates
- 100% Transparency
- Free of Optics & Games
Specialty Drug Management
- Alternative Funding Solutions
- Strong Clinical Programs: (PA, UM, Step Therapy, QL, Split Fill)
- Patient Engagement & Coaching
- Copay Card/Accumulator Programs
Experienced Stop-Loss Coverage
- Competitive Rx-Only Stop-Loss Protection
- Plan Design Recommendations
- ERISA Consultation
- Medical Channel Management
Expert Predictive Analytics Solutions
- 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
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 +
47%
$350k +
$200k+
28.3%
1st-Year Savings
$350k +
Advanced Clinical Insight
Partnership: Crumdale Partners worked alongside the broker to understand the current PBM solution and contract to provide a program with transparency and accountability.
Results: The newly proposed PBM program from TRx offered a signature-ready contract and proposal that would immediately yield significant savings based on current member utilization while improving the overall employer experience and resulting in minimal member disruption.
results
Specialty Cost Containment
Case Studies
06 case results
Average Plan Savings: 61.1%*
CLIENT | Plan cost without program | PMPM Without program | Plan Cost With program | PMPM With program | Savings ($) | 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 |
Delivering Client Value:
Case Studies Across Industries
|
|
|
|
|
|
---|---|---|---|---|---|
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