RFP Preparation Checklist
- 3 years of claims data: Complete pharmacy claims data for accurate pricing
- Current contract: Current PBM contract for comparison
- Plan demographics: Member count, age distribution, geographic distribution
- Current formulary: Current formulary for comparison
- Objectives: Defined cost, clinical, and service objectives
- Evaluation criteria: Weighted criteria for evaluating proposals
- Timeline: Defined RFP timeline with key milestones
Evaluation Criteria
| Criterion | Weight | Key Questions |
|---|---|---|
| Net cost | 40% | What is the total net cost including all fees, rebates, and credits? |
| Transparency | 25% | Is the contract pass-through? Are all revenue sources disclosed? |
| Clinical capabilities | 20% | What are the UM, DUR, and specialty management capabilities? |
| Service quality | 10% | What are the member satisfaction scores and turnaround times? |
| Implementation | 5% | What is the implementation process and timeline? |
Pharmacy Consultant Value
IQ Insight
A pharmacy consultant with PBM RFP experience can significantly improve RFP quality and negotiation outcomes. Consultants know what to ask for, how to evaluate proposals, and how to negotiate contract terms. The consultant's fee — typically $15,000–$50,000 — is typically recovered many times over in improved contract terms and net cost savings.