“Operating with a true risk management focus and always in the best interests of the client is very liberating for health plans and employers in terms of the strategies we can provide to benefit plan sponsors and participants…we believe that the fiduciary mindset offers a valuable roadmap for what every organization should expect from all vendors, including their PBM and health plan carriers.”
-Renzo Luzzatti, President, US-Rx Care
It’s true—when facing the realities of just how expensive pharmacy benefits have become, more and more groups are realizing that the traditional PBM model just isn’t working in their favor. For those looking for both savings, integrity, and compliance, the fiduciary model has proven to be nothing short of game changer.
An ‘F’ Word that Packs a Punch
In the health benefits space, the term “fiduciary” carries some serious weight. Under the Employee Retirement Income Security Act of 1974 (ERISA), a fiduciary is defined as “any person or entity that exercises, administers, or advises discretionary control over plan management and assets.” And this comes with a crucial legal obligation: to act solely in the best interests of the plan and its participants.
In simpler terms, a fiduciary PBM must:
- Prioritize the plan and its members above all else
- Avoid all conflicts of interest, including third-party incentives
- Disclose all financial arrangements
- Provide total transparency on costs and utilization
Unlike traditional PBMs that often profit from opaque deals, rebates, and spread pricing, a fiduciary PBM removes these hidden profit centers entirely. This level of transparency enables better decision-making and ensures that cost-saving strategies aren’t just smoke and mirrors—they’re real, measurable, and aligned with your best interests.
Results That Speak for Themselves
Groups who move to a fiduciary PBM model—like US-Rx Care—often experience immediate and significant cost reductions by:
- Eliminating wasteful spending
- Optimizing drug utilization
- Getting back 100% of negotiated savings to plan sponsors
But the true fiduciary advantage is more than just savings. It’s about aligning your company’s values and fiduciary duty with its PBM. It’s about accountability. And ultimately, it’s about doing what’s right for your employees—providing them with access to high-quality, affordable care without compromise.
The result? A sustainable solution that delivers better care for employees and a healthier bottom line for your business.
The US-Rx Care Difference
Have you been told: “You should be happy with annual increases that don’t reach double digits.” This is a myth that has pervaded the industry for years by both PBMs and those hanging onto the status quo. At US-Rx Care, we have never accepted the status quo. We provide self-insured employer and health plan employees with fiduciary compliant, pharmacy benefits risk management services that leverage a level of clinical rigor, administrative tools, perspectives, and approaches that have been honed, perfected, and time-tested for close to three decades. Our clients typically see between a 30-50% reduction in pharmacy benefits spend—with no change in benefit designs and minimal member disruption. Plan participants also typically enjoy a 30% reduction in out-of-pocket costs and are appreciative of the time and effort expended on their behalf to optimize their drug therapy and lower their spend.
What can the fiduciary PBM model deliver for you and your business? Let’s talk! Schedule a meeting at usrxcare.com/contact.