Recommendations

As optional, value-added point programs, PCM Recommendations support plan cost containment and clinical support strategies.

PCM Pharmacy Savings

3

With PCM Pharmacy Savings, plans contain costs by engaging physicians to switch participants from high-cost to low-cost drugs.

Lowest cost switches

Specialty identification

Proactive participant engagement

Validated PMPM savings

Full-suite reporting

The Pharmacy Savings Process

PCM does the work. Your plan sees measurable, long-term pharmacy savings.

Recommendations Pharmacy Savings Savings Process 1

Identify low-cost Rx alternatives.

Recommendations Pharmacy Savings Savings Process 2

Engage physicians.

Recommendations Pharmacy Savings Savings Process 3

Gain participant approval.

Recommendations Pharmacy Savings Savings Process 4

Facilitate Rx fill.

Participant Engagement

PCM’s team of Licensed pharmacists and certified pharmacy techs make navigating pharmacy care simple:

Personalized pharmacy education

Proactive outreach on savings opportunities

Lower out-of-pocket costs

Expert guidance for improved clinical outcomes

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Plan Savings

PCM Pharmacy Savings helps plan sponsors and participants lower prescription drug costs at the source:

No plan changes required

Quick implementation

Limited HR workload

Minimal participant disruption

Lower patient copays

See where your money is going with a complimentary analysis.

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Cost Containment

3

Engage participants and providers to act on high-cost drugs. Our dedicated support team is here to do the heavy lifting.

Flexible implementation

Comprehensive reporting

Measurable PMPM savings

Interactive management platform

Consolidated claims

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Recommendations Cost Containment Program Alt Funding

Alternate Funding

No plan changes
$0 participant co-pay
High case approval rates
Lower specialty spend

Recommendations Cost Containment Program International

International Rx

No medication changes
Direct to participant shipping
Automatic Rx identification
Low participant disruption

Rx Tourism

5-star facilities
Full-service concierge
Locked-in rates
Up to 70% savings

Build a supplemental pharmacy and medical benefit program to optimize your benefits strategy.

A la carte model

Flexible service levels

Customized integrations

In-house engagement

Program validation

Built to Suit

With customized program integrations, PCM helps you build a plan-specific program.

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Build a plan-specific cost containment program with PCM.

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Clinical Review

3

Targeted solutions focused on balancing clinical outcomes and costs to prioritize participant health.

Patient-focused care

Reduced medical costs

More pharmacy savings

Improved treatment outcomes

Participant engagement

Specialty Review

Treatment of complex conditions can be costly. Specialty Review allows plans to manage financial costs and improve health outcomes one person at a time.

Model-based care management

Personalized specialty drug treatment

Reduced out-of-pocket spend

What is Specialty Review?

Utilizing real-world evidence, Specialty Review is a model-based care management solution that drives personalized specialty treatment. This, in turn, provides your participants with:

Individualized Care Planning

Specialty plans tailored to
meet participant needs.

Recommendations Clinical Review What is Specialty Review Limited disruption

Hassle-Free Implementation

Easy, anytime implementation with limited participant disruption.

Precision PGx

Based on drug-gene interaction, PGx identifies a participant’s metabolic rate which encourages doctors and patients to make informed decisions, resulting in: