The health plan pursued a bold strategy, co-owning its own PBM through a joint venture with the NeosRx team built on a transparent, cost-plus model. This approach fundamentally shifted pharmacy benefits from a black-box expense into a strategic asset.
Traditional PBMs introduced opaque pricing structures, limited visibility into rebates, and misaligned incentives that rewarded higher drug costs. The result was reduced flexibility, rising specialty spend, and fewer actionable insights to support value-based care. Leadership sought a model that prioritized clinical outcomes, financial stewardship, and member experience without sacrificing access.
By owning its PBM, the University of Utah Health Plan gained full control over pharmacy strategy. Key elements included:
“With full drug utilization transparency, we now have greater control over pharmacy costs, formulary decisions, and rebate management. This means lower costs, faster access to medications, and enhanced service for our members.”
Laura Britton, PharmD, Director of Pharmacy for University of Utah Health Plans
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