DRA-12128 - USA (Lexington, Kentucky) - Pharmacy Claims Data Analytics and Auditing Services - Deadline November 24,2026

(1) Vendor needs to provide pharmacy claims data analytics and auditing services to the government authority located in Lexington, KY.• The successful contractor will aggregate, normalize, and analyze multi–year pharmacy claims data, alongside medical claims and eligibility data where available, for its covered populations. – The primary objective is to deliver independent decision support, actionable financial insights, and robust analytics that drive Pharmacy Benefit Manager (PBM) oversight, clinical program evaluation, contract enforcement, and strategic cost containment.– Data Aggregation, Integration, and Data Integrity• Ingest pharmacy claims, eligibility, and other applicable data from multiple PBMs and client organizations;• Integrate medical claims and other healthcare data when available;• Support appropriate industry–standard data/file formats and secure data–transfer methods;• Validate incoming data for completeness, accuracy, duplication, formatting errors, and other data–quality concerns;• Provide reconciliation processes for rejected, incomplete, duplicate, or anomalous records;• Maintain traceability between source data and normalized/processed data sufficient to support review and audit;– Drug Pricing and Cost Opportunity Analysis• Analysis should include, as applicable:• Brand and generic drug pricing;• Specialty drugs;• Biosimilars;• Formulary alternatives;• Site–of–care opportunities;• Pharmacy and network pricing variations;• Drug classification changes;• Material mid–year price changes(2) The contract period will be for one year.