Latest Articles
Analysis and perspective on direct-to-employer pharmacy programs, drug benefit integrity, and the structural changes reshaping pharmacy benefits.
How to Audit Your PBM: A Practical Action Guide for Self-Funded Employers
Most self-funded employers have never audited their PBM. Under ERISA and CAA 2026, that is a fiduciary risk. Here is a practical step-by-step guide to evaluating your PBM arrangement and documenting prudent oversight.
Read MoreCAA 2026 and Pharmacy Benefits: What Self-Funded Employers Must Do Now
The Consolidated Appropriations Act of 2026 created new PBM disclosure requirements, rebate pass-through mandates, and fiduciary obligations for self-funded employer health plans. Here is what changed and what plan sponsors must do.
Read MoreHow to Evaluate PBM Fiduciary Alignment: A Practical Guide for Plan Sponsors
Not all PBMs are fiduciary-aligned. Here is what genuine fiduciary alignment requires, how to evaluate your current PBM against that standard, and what to do when the arrangement falls short.
Read MoreERISA Fiduciary Duty and Pharmacy Benefits: What Every Self-Funded Employer Must Know in 2026
Plan fiduciaries face personal liability for pharmacy benefit decisions under ERISA. Here is what the prudent expert standard requires, what CAA 2026 changed, and how to demonstrate compliance.
Read MoreHow to Evaluate a Direct-to-Employer Pharmacy Platform: Five Questions to Ask
Not all direct-to-employer pharmacy platforms are equivalent. Here are the five structural questions that separate genuine pharmacy benefit infrastructure from clinical wrappers and cash-pay workarounds.
Read MoreWhat Benefits Consultants Need to Know About Manufacturer-Direct Pharmacy Programs
Manufacturer-direct pharmacy programs are arriving in employer benefit conversations faster than most consultants are prepared for. Here is what the model actually requires and how to evaluate it for clients.
Read MoreGLP-1 Employer Benefit: Manufacturer Direct vs. PBM -- What's the Actual Cost?
PBMs report low net GLP-1 costs. Manufacturers are offering direct pricing. Here is how to compare the two channels accurately and what self-funded employers are actually paying.
Read MoreERISA, CAA, and the Self-Funded Employer's Duty to Evaluate Direct Drug Channels
CAA 2026 raised the bar for pharmacy benefit fiduciary oversight. Self-funded employers now face personal liability for drug benefit decisions they cannot document. Here is what that means in practice.
Read MoreHow Manufacturers Can Launch a Direct-to-Employer Drug Program
Launching a manufacturer direct-to-employer drug program requires more than pricing. Here is the operational infrastructure required to make a DTE channel work inside an employer benefit.
Read MoreWhat Is a Direct-to-Employer Pharmacy Benefit Program?
A direct-to-employer pharmacy benefit program lets self-funded employers access manufacturer-direct drug pricing inside their benefit, bypassing PBM intermediaries for targeted high-cost drugs.
Read More