Pricing: Full Disclosure

Under the SWPS full disclosure, fully transparent pricing model, all costs are pass-through and 100 percent of collected rebate is returned to each client. The only money SWPS retains from any source is the administrative fee, which is charged only on paid claims, not denied claims.

SWPS utilizes a national pricing data source for AWP and is updated weekly. We believe in full disclosure pricing and do not manipulate the pricing or the time ranges.

No "pricing games"

SWPS does not play "pricing games" by using any type of spread pricing (i.e. paying the pharmacy one rate and charging the plan a different rate) 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). All costs are passed through to the client at the same rate that is charged by the pharmacy. Therefore, any additional savings are passed 100 percent back to the client.

No "re-packaging"

One mechanism employed by many PBMs is called "re-packaging," a technique where PBMs split bulk shipments to smaller sizes and artificially inflate the AWP. We have hard-coded edits in the system to detect and prevent this inflated pricing. We also use "lesser of" logic for both the plan-paid and member-paid pricing, which results in the best deal for both the member and the plan.

Unlike traditional PBMs, SWPS also considers all monies from pharmaceutical manufacturers, under any name, to be considered "rebate." 100 percent of collected rebates are returned to the client.