What is one specific PBM contract clause you’ve negotiated—such as exclusions for copay accumulator/maximumimizer programs or true-up guarantees—that materially reduced specialty pharmacy spend? What data point most persuaded the PBM?

Negotiating PBM contracts is crucial for managing specialty pharmacy costs. One key clause I've secured is the exclusion of copay accumulator programs. These programs can reduce upfront medication costs for patients but ultimately increase overall expenses for employers and insurers by preventing manufacturer copay assistance from counting towards deductibles and out-of-pocket maximums.