Is transparency alone a guarantee for a sponsor to receive the best PBM value?

While transparency in pharmacy benefit management (PBM) is essential for understanding drug pricing, cost structures, and the services provided, it does not independently ensure that a sponsor will receive the best value from their PBM. Transparency allows sponsors to identify and evaluate different pricing models, potential hidden fees, and rebates, but it must be paired with effective negotiation, competitive benchmarking, and rigorous contract management to truly secure the best value.

Various factors impact the quality of a PBM relationship and the value received, including the specific contractual terms negotiated, the expertise of the sponsor’s team in interpreting and utilizing data, and the competitive landscape of available PBMs. Without a comprehensive strategy that incorporates not just transparency but also active engagement in managing the relationship and performance metrics, a sponsor may not realize optimum value. Therefore, transparency is a critical component, but it is not a standalone guarantee for achieving the best PBM value.