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How Pharmacy Benefit Dimensions® Works

There are many components to the pharmacy system, and we play a role at every level to better manage each element for you and your employees.

Plan Sponsor

We deliver solutions to maximize your cost savings and enhance clinical effectiveness while exceeding customer expectations through exceptional service. You’ll benefit from our:

  • Consultative team of pharmacists, account managers and financial analysts dedicated to your accounts.
  • Significant experience in implementing cost and care programs with employers.
  • Quarterly newsletters and industry updates to keep you aware of changing trends.

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Pharmacy

We work with pharmacies to negotiate deep discounts and manage communications, offering greater control over decisions that influence both costs and quality medical outcomes.

  • State-of-the-art claims processing
  • Claims are submitted in real time and are HIPAA compliant
  • National network of 58,000 pharmacies in all states
  • 24/7 help desk to respond to pharmacy inquiries

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Member

Our member-centric service model provides more value and satisfaction for your employees.

  • State-of-the-art technology
  • Custom communication materials
  • Quarterly newsletters
  • Online account access and claims review

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Clinical Programs and Reporting

By monitoring prescription usage, we help identify the lowest cost, most-effective therapy to treat conditions.

  • Right drug, right dose, right price
  • Industry-leading Drug Utilization Review (helping to improve safety and reduce misuse of prescription drugs)
  • Most cost-effective drugs (generic vs. brand)
  • Maximum daily dose (appropriate dosage based on FDA)
  • Prior authorization
  • Appropriate refills at the point of dispensing
  • Step therapy
  • Therapy duplications (redundant drug usage)
  • Medication Therapy Management

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Pricing

Our flexible pricing models help deliver exceptional value and deep discounts.

  • Transparent or traditional pricing models
  • Aggressive pricing on generic drugs – MAC (Maximum Allowable Cost)
  • Industry-leading, brand-name drug discounts
  • Competitive specialty drug discounts
  • Cost-effective mail order alternatives

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Formulary Management

Together, we will work with you to develop a list of covered drugs and tiers.

  • Focus is on highest quality, lowest net cost rather than highest rebate
  • Formulary options with flexibility to meet your employees needs
  • Clinical evidence-based decision making
  • Independent Pharmacy and Therapeutics Committee

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