A mid-sized health plan serving more than 500,000 members across multiple lines of business launched an ambitious transformation to become a market leader. Drug benefit redesign was a critical lever to achieving several interconnected goals.

Despite spending more than $2 billion annually on pharmacy benefits, the organization struggled with transparency issues, rising costs, and misalignment between its pharmacy benefit manager (PBM) model and long-term strategic vision. To address these issues, the health plan engaged AArete to rethink the financing, design, and delivery of drug benefits.