Renzo Luzzatti, Founder and CEO of US-Rx Care, discusses the role and practice of the Pharmacy Benefits Managers and the advantages of working with a company that uses a fiduciary model. Inherent conflicts of interest in the traditional PBM model, such as manufacturer rebates and requirements to use PBM-owned pharmacies, drive up prescription drug costs. US-Rx Care eliminates these conflicts by charging a flat administrative fee with its sole incentive to lower drug costs for the plan and its members.

Renxo explains, "We've been around since 2007. We do have about 5 million lives under management, both self-funded employers, which is the bulk of our business. Then we also tap into Medicare health plans and have some programs and offerings that we assist there to lower costs and improve the quality of care. Our approach is unique in that we've taken a fiduciary stance from day one. We can talk about that in a little bit. It is a legal term. It's defined under ERISA, which governs health plans. They have a fiduciary duty to the plan, the members, and the management of the plan assets. And the industry as a whole has shied away from any fiduciary obligation whatsoever, in part because it's rife with conflicts of interest, and you cannot have conflicts of interest as a fiduciary."

"That is really at the core of all of the issues and complaints that we're hearing about PBMs - they're driving up the cost of prescriptions rather than having the intended effect, which is to reduce the cost of prescriptions. And I would say in the last four or five years, employers have really started to ask the right questions because they're becoming more and more educated."

"For folks like us, we're growing like crazy because the industry finally gets that. The deal that they were getting through their traditional model is not so good. The other thing is when we move to a fiduciary model, savings are typically in the realm of 30% to 50% in the first year, and then we typically see additional savings in year two and three, and then after that, the goal and the intent, which we've been successful at, is to keep costs stable."

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