CHANNEL PRICING · AUDIT WORKSHEET
Same Drug. Three Channels. Three Prices.
The Audit Worksheet to Surface the Gap.
A 2-page printable framework PBS uses across 100s of PBM contract reviews annually. Free download. Sent to your inbox.
3 audit passes plan sponsors run on per-channel net cost
Paste-ready PBM data request (drop into a broker email)
The pattern PBS sees most often across 100s contracts/year
4-step action plan you can execute this quarter
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A complete audit framework you can run in half a day.
WHAT IS IN THE WORKSHEET
PASS 03
Compare the contract clause
Run the 5-line calculation on per-channel net cost. The pattern PBS sees most often: PBM-owned specialty channel runs materially higher than the network-membership clause suggests.
PASS 01
Pull the channel-pricing data
Open your most recent quarterly report. Pull per-channel net cost across retail, mail, and specialty. The data is in your claims; the framing is in the worksheet.
PASS 02
Calculate the spread
Run the 5-line calculation on per-channel net cost. The pattern PBS sees most often: PBM-owned specialty channel runs materially higher than the network-membership clause suggests.
ACTION PLAN
4-step quarter plan
Pull the data. Calculate the spread. Compare to the contract. Bring the documented gap to your broker before the next quarterly review. The worksheet has the data-request copy you can paste directly into the email.