Clarity Starts Here
Healthcare costs are rising—and pharmacy benefits have become one of the most complex and misunderstood parts of the system. These FAQs break down how Navion helps organizations reduce costs, optimize PBM contracts, and navigate pharmacy benefits with clarity and confidence.
What is a pharmacy benefit consultant?
A pharmacy benefit consultant helps employers, brokers, benefit consultants and TPAs evaluate PBM contracts, manage pharmacy spend, improve benefit strategy and hold pharmacy vendors accountable.
How does Navion help reduce pharmacy benefit costs?
Navion analyzes claims, contracts, rebates, pricing terms and utilization trends to identify savings opportunities, then helps organizations turn those findings into action. That can include vendor negotiations, PBM audits, specialty drug strategies, clinical programs and ongoing performance monitoring designed to reduce unnecessary spend without sacrificing member access.
How do you know if your PBM contract is performing?
A PBM audit helps verify whether rebates, discounts, guarantees and contract terms are being delivered as promised. Routine audits, market checks, rebate validation, claims analysis and ongoing performance monitoring can uncover rebate underpayments, errors and missed savings opportunities while showing whether the contract is truly performing.
What are pharmacy benefit analytics?
Pharmacy benefit analytics use claims data, contract terms, drug classifications, rebate assumptions and market insights to understand what is driving pharmacy spend and where action may be needed.
Does Navion replace a PBM?
No. Navion works independently alongside PBMs, brokers, TPAs and plan sponsors to evaluate performance, improve strategy and strengthen vendor accountability.
Why are pharmacy costs rising?
Pharmacy costs are rising because of specialty medications, GLP-1 demand, new innovative but costly therapies, biosimilars, changing rebate dynamics and increasingly complex PBM contract structures.
What does Navion do?
Navion helps organizations make data-driven pharmacy benefit decisions through PBM consulting, contract optimization, pharmacy analytics, audits, clinical strategy and cost-containment support.
What is PBM contract optimization?
PBM contract optimization is the process of reviewing PBM pricing, rebates, guarantees, exclusions, audit rights and contract terms to improve financial performance and accountability.
What is a PBM reprice or savings analysis?
A PBM reprice compares current pharmacy claims and contract terms against alternative pricing models to estimate potential savings and support data-driven vendor decisions.
What are pharmacy cost-containment strategies?
Pharmacy cost-containment strategies help organizations manage prescription drug spend through tactics such as specialty drug management, formulary review, PBM audits, rebate optimization, biosimilar strategy, alternative funding evaluation and contract improvements. These strategies are designed to support appropriate use, reduce unnecessary costs and protect member access.
Why is independent PBM consulting important?
Independent PBM consulting gives organizations objective guidance that’s not tied to a specific PBM, vendor or funding model. That independence helps keep recommendations focused on the client’s goals.
