Independent PBM Comparison
| PBM | Model | Key Features | Best For |
|---|---|---|---|
| Capital Rx | Pass-through; fiduciary | JUDI technology platform; full transparency | Employers seeking fiduciary PBM |
| SmithRx | Pass-through | Simple pricing; strong analytics | Mid-size employers (200–2,000 employees) |
| Navitus | Pass-through | Cooperative model; strong rebate pass-through | Employers seeking cooperative model |
| RxBenefits | Purchasing cooperative | Aggregates purchasing power for smaller employers | Smaller employers seeking scale |
Evaluating Independent PBMs
Evaluating independent PBMs requires comparing net costs — total drug cost including all fees, minus all rebates and credits. Request a net cost analysis from each PBM using your actual claims data. Compare net costs across PBMs — not just administrative fees. Also evaluate: network breadth, specialty pharmacy capabilities, analytics, and member services.
The Transition Risk
IQ Insight
Transitioning to an independent PBM involves transition risk — member disruption, formulary changes, and pharmacy network changes. Mitigate transition risk by: (1) allowing members to continue current medications during a transition period; (2) communicating the transition clearly to members; and (3) selecting an independent PBM with a strong transition management process. The long-term savings typically justify the short-term transition risk.