PHAR-2281 - USA (Chelsea, Massachusetts) - Pharmacy Benefit Consulting Services - Deadline December 3,2026

(1) Vendor needs to provide pharmacy benefit consulting services to the government authority located in Chelsea, MA.– Evaluation of carve–in versus carve–out:– Evaluation of both carve–in and carve–out options, including the financial, contractual, administrative, member–service, and operational implications of each approach.– Analysis of the impact of a carve–out on the City's medical arrangements, including integration of accumulators, clinical programs, care management, reporting, and any effect on medical rates, fees, or contractual terms.– Contract negotiation:– Particular attention to contract definitions, including the definitions of generic, brand, specialty, limited distribution drug, rebate, administrative fee and similar terms, and to the ways in which those definitions can erode the value of stated guarantees.– Financial analysis of proposals:– Detailed review of financial proposals to ensure that comparisons are made on a consistent basis and that proposed savings are realistic and appropriately modeled.– Presentation of results in a format suitable for review by city officials, the insurance advisory committee, and other stakeholders who are not pharmacy specialists.– Ongoing claims review and monitoring:– Ongoing pharmacy claims review and monitoring, including utilization trends, specialty pharmacy, high cost drugs, emerging therapies, and other significant cost drivers.– Early identification of new high–cost claimants, new–to–market therapies, and pipeline drugs likely to affect the city's spend.– Market monitoring:– Ongoing evaluation of the PBM marketplace and recommendations regarding contract improvements, market checks or other opportunities that may arise during the contract term.(2) All the questions must be submitted no later than November 19, 2026.(3) The contract period will be for three years.