Pricing: Transparent Pricing

Scott & White believes that we offer a unique product in the PBM marketplace. Unlike most of the major PBMs, we believe in full disclosure pricing. SWPS is continually looking for ways to save both the patient and the plan money, and believe our track record bears this out.

Managing your plans like we manage our own

Our philosophy is to manage our clients' plans like we manage our own, by keeping total net costs low. The result is low year-over-year cost trend. We strongly believe that there is significant cost savings potential in most plans that the major PBMs have no incentive to manage.

SWPS offers a host of cost containment services to all clients. Of primary importance, we embrace and promote our full disclosure pricing model.

Unlike SWPS, traditional PBMs have multiple layers of "hidden fees" in the cost of the drugs, as well as in many other areas of the program.

Pass-through pricing model

In essence our structure is a "pass-through" pricing model with no spread in any component of the pricing system. SWPS does not play pricing "games" by using any type of spread pricing or spreading the timeframe of the AWP lists (i.e. using an old list to pay the pharmacy and the most current list to charge the client to take advantage of the typical positive inflationary trend). Under our pricing model, while we do not promote rebatable drugs, 100 percent of collected rebate is returned to clients.

Best deal for the member and the plan

SWPS requires the manufacturer's original 11-digit NDC be used to process claims; this enables us to detect and prevent re-packaging, which is a technique traditional PBMs use to split bulk shipments in smaller sizes and artificially inflate the AWP.

We also use "lesser of" logic for both the plan paid and member paid pricing on generic drugs, which results in the best deal for both the member and the plan.

Low administrative fee

The one low administrative fee encompasses our standard claims processing, invoicing, clinical management (including the standard PAs), reporting, member education, monthly newsletter, website services, customer service center, on-site client meetings and our annual forums as described below. Unlike some traditional PBMs, we also charge administrative fees only on paid claims, not denied claims.

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