Pharmacy Benefit Consulting by Genesys

Our Services

Our expertise spans a wide range of areas, allowing us to provide tailored solutions that align with your organization's goals and employee health needs.

Plan Design Analysis

Understanding the current state of your pharmacy benefit plan is the first step toward improvement. We conduct a thorough analysis to identify strengths, weaknesses, and areas for enhancement. This analysis guides our recommendations for plan design changes that maximize value and efficiency

Cost-Containment Strategies

Rising prescription drug costs can be a significant burden on both employers and employees. We develop customized cost-containment strategies that help manage these costs without compromising the quality of care. Our solutions include innovative approaches to drug utilization, formulary management, and pharmacy network optimization.

Formulary Management

A well-managed drug formulary can make all the difference in controlling costs and ensuring appropriate medication use. We evaluate and optimize your formulary, focusing on cost-effectiveness, clinical guidelines, and alignment with your overall benefits strategy.

Pharmacy Network Evaluation

Having access to a reliable and cost-effective pharmacy network is critical. We assess your current network to ensure it provides sufficient coverage, competitive pricing, and convenient access to prescription medications. If needed, we assist in reconfiguring your network for optimal results.

We operate with flexibility and agility, enabling us to adapt to changing circumstances and deliver projects on time.

Utilization Review

Understanding how your employees use prescription drugs is key to managing costs and promoting health. We analyze utilization patterns to identify trends, opportunities for improvement, and areas of concern. This data-driven approach allows us to recommend changes that reduce waste and encourage proper medication adherence.

Specialty Pharmacy Management

Specialty medications often come with unique challenges. We develop strategies to manage these high-cost drugs effectively, including specialty pharmacy network management, patient support programs, and efficient prior authorization processes.

Drug Pricing Negotiation

Securing favorable pricing for prescription drugs plays a significant role in cost containment. We negotiate pricing agreements with pharmaceutical manufacturers, pharmacy benefit managers (PBMs), and other vendors to ensure you get the best possible prices for your pharmacy benefits.

Clinical Support Services

Our clinical support services aim to enhance medication therapy management and improve patient outcomes. We offer programs that promote medication adherence, assist with drug utilization reviews, and streamline prior authorization processes, ensuring employees receive the medications they need without unnecessary hurdles.

Benefit Integration

Your pharmacy benefits should work seamlessly with other employee benefits programs. We ensure that your pharmacy benefits are integrated with medical insurance and wellness initiatives, creating a cohesive and comprehensive benefits package.

Employee Education

Educated employees are more likely to make informed decisions about their health. We provide educational resources and communication materials that explain medication coverage details, cost-sharing requirements, and ways to save on prescription drugs.

Compliance Review

Compliance with laws and regulations like ERISA, ACA, and HIPAA is non-negotiable. Our compliance review services ensure your pharmacy benefit plan adheres to all relevant regulations, reducing the risk of penalties and legal issues.

Data Analytics

We use advanced data analytics to monitor pharmacy claims data and utilization metrics. This allows us to identify trends, track performance, and recommend adjustments that enhance the effectiveness and efficiency of your pharmacy benefits program.

Vendor Evaluation and Annual Review

Choosing the right vendors is crucial to the success of your pharmacy benefits program. We assist in selecting and evaluating pharmacy benefit management vendors, specialty pharmacies, and other service providers, ensuring you work with quality partners at competitive pricing.

Ongoing Support

The world of pharmacy benefits is a dynamic one, constantly evolving and presenting new challenges. However, with Genesys by your side, you can feel secure. Our ongoing support and consulting services are designed to keep you up-to-date on regulatory changes, emerging issues, and new opportunities, providing support and security in managing your pharmacy benefits program.


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