PBMs

Contain costs. Reach clinicians.

See how Surescripts fuels innovation for pharmacy benefit managers (PBMs) with actionable patient intelligence.

Managing prescription drug costs has never been more important.

Your clients look to you for innovative solutions to keep patients healthy and satisfied while reducing the total cost of care. Today, that’s more challenging than ever.

Medication costs keep rising.

More and more patients are managing chronic conditions. Advances in life sciences are promising—but the price tag is often high.

  • Nearly a third of U.S. patients now face three or more chronic conditions. 1
  • By 2022, branded specialty drugs are projected to exceed half of medicine spending in the U.S. 2

Administrative burden adds up.

You have the data needed to optimize medication decisions in a complex market. But without easy access to your insights, providers struggle with rework and paperwork.

  • U.S. physicians cite “too many bureaucratic tasks” as their #1 cause of burnout. 3

Together, we create a more efficient system based on real-time access to your expertise.

I need to...

Help prescribers choose cost-effective, on-formulary medications.
Automate prior authorizations.
Deliver time-sensitive updates to prescribers in their workflow.
Address nonadherence, gaps in care and other medication concerns.

Eligibility

Provide insight into preferred medication options at the plan level, with help from features including a primary coverage indicator.

Formulary

Easily indicate drug formulary status, tier, and availability of mail-order service based on the patient’s benefit plan.

Real-Time Prescription Benefit

Show out-of-pocket costs, coverage, alternatives, prior authorization requirements and more, protected by safeguards like anomaly detection.

Electronic Prior Authorization

Automatically send questions directly to prescriber workflows, receive answers and attachments, send responses and initiate renewals.

Clinical Direct Messaging

Send prescribers important updates about formulary changes, drug safety notices and gaps in care via a secure, HIPAA-compliant solution.

Medication History

Deploy your claims data to show clinicians which medications patients have filled, providing reliable insight into adherence behavior.

From your organization to the point of care

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A strong network with nationwide reach

Surescripts provides a single point of connection to clinicians nationwide.

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Two decades of partnership with PBMs

Since our founding, we’ve worked closely with PBMs to lower the cost of care.

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Support in engaging your plans

Tools to drive health plan engagement help you see faster results from our solutions.

Where information gaps could create care gaps, we’re on it. See our impact.Where information gaps could create care gaps, we’re on it. See our impact
Where cost concerns threaten medication adherence, we’re on it. See our impactWhere cost concerns threaten medication adherence, we’re on it. See our impact
Where trust matters most, we’re on it. See our impactWhere trust matters most, we’re on it. See our impact

Contact us for more information

  1. Rand Corporation, “Chronic Conditions in America: Price and Prevalence,” Rand Review, July 12, 2017.
  2. IQVIA Institute for Human Data Science, “2018 and Beyond: Outlook and Turning Points,” March 2018.
  3. Leslie Kane, “Death by 1000 Cuts': Medscape National Physician Burnout & Suicide Report 2021,” Medscape, January 22, 2021.