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Pharmacy services
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Pharmacy Services

Enhancing patient outcomes, driving healthcare-delivery efficiencies, and developing effective strategies across the pharmacy value chain
Several important trends are reshaping the pharmacy industry, altering the value pools and basis of competition within it. Through a holistic view on the pharmacy value chain, we have enabled retail pharmacies, wholesalers, pharmacy benefit managers (PBMs), providers and payers to rethink inflection points, areas of focus, and disruption over the coming years.

What we do

Strategic planning for disruptions in the value chain

We assist organizations through the development of their go-forward strategy as they navigate potential regulatory and competitive disruption in the pharmacy-services industry.

Healthcare-delivery efficiency through improved quality and medication management

We guide the design and implementation of pharmacy-services solutions across a range of levers, including lean optimization, demand management (for example, streamlining a prior-authorization list), digital automation (such as building intelligent web intake and technology-enabled reviews), and improved organizational culture and processes.

Effective planning and management of pharmacy costs

We help organizations better manage their pharmacy spend through a combination of predictive analytics, proprietary data sets, and implementation expertise (from contracting to process design).

3–5%

pharmacy-spend reduction

for payers

2–5%

annual decrease

in provider spend in pharmacy supply chain

Featured capabilities

We help our clients develop an informed strategic decision for the next phase of growth by investing in proprietary tools and databases.

Therapeutic-equivalent drug substitution: We use spend and utilization data in the rapid identification of opportunities for improving the adoption of medically appropriate preferred products within select therapeutic areas.

Pharmacy-price-variability tool: Our comprehensive, SKU-level matching algorithm leverages proprietary analytics logic to evaluate and optimize organizations’ entire purchase-order databases.

Forward-purchasing tool: Our analytics solution for providers incorporates industry forecasts to allow for better inventory management in advance of anticipated product-price changes.

Pharmacy-price-arbitrage tool: Our rapid diagnostic tool assesses pharmacy purchasing across facilities to help identify incorrect contract pricing.

Rapid assessment of medical policies: We use a proprietary database to assess and structure medical policies that will improve quality outcomes, based on industry benchmarks.

Examples of our work

Value-creation opportunities

A state was seeing rising costs of its Medicaid program, especially in pharmacy spend. We developed several initiatives, including traditional utilization-management levers, a rebate-capture strategy, and novel contracting, to save the state 3–5 percent of its total pharmacy spend.

Design-to-value approach

A health system was looking to optimize its supply chain as part of becoming more financially sustainable. We helped improve its performance in pharmacy services through formulary management, inventory enhancement, and contracting techniques to save approximately $10 million (around 3 percent) per year in its supply chain.

Comprehensive pharmacy contracting optimization

We helped revamp an organization’s pharmacy contracting, including end-to-end contract renegotiation for its pharmacy benefit manager, narrowing of formularies, and selection of the most appropriate formularies across all segments of the business (commercial, Medicaid, and Medicare). This created a total savings of more than 7 percent of pharmacy cost during the program’s first 12 months.

Next generation rebate billing and payment system

We designed the detailed clean-sheet future state processes and IT solutions needed to transform rebate processing, identified $100M+ in run rate impact through automation, increased accuracy, accountability and visibility. Developed a detailed list of 30+ initiatives to enable single source of truth/operational data store, automate workflow engine and enable POS rebates and monthly billing for pharmaceutical companies.

Renergizing go to market strategy

Supported pharmaceutical wholesaler in transforming its customer facing operations to unlock over $300M in value through more nuanced, analytically driven customer segmentation and the development of comprehensive value propositions tailored to the unique needs of induvial customer segments. Redesigned internal organization and operating model to better support field activities and streamline internal bureaucracy and redundancy.

Retail pharmacy strategy

Conducted in-depth analysis of market dynamics – population density, condition density, health plan penetration and membership dynamics, PBM affiliation, network constructs, etc. – in order to identify and prioritize growth opportunities for leading retail pharmacy. Able to identify market-level strategies to drive growth and differentiate in-store offerings relative to competitors, based on the unique needs of the local populations and regional health plans.

Featured insights

Article

Trends disrupting pharmacy value pools and potential implications for the value chain

– Changes in the pharmacy industry are altering the value pools and basis of competition within it. Three moves can help players... respond successfully to these changes.
Article

Distributed sites of care: At the tipping point?

– Increasingly, consumers are seeking services at sites of care outside of the traditional health system infrastructure. This shift... has important implications for how health systems think about their asset base and scale.

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