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Optimize Without

Minimal Change For Your Members,
Maximum Savings for You

With our Optimized Network Efficiency (ONE) Method, we’ll help you optimize your pharmacy benefit by recommending the best pharmacy network based on your goals for cost savings and member access. An optimized pharmacy network delivers choice for acute and maintenance medication coverage, plus, added clinical support so you can focus dollars on other member benefit priorities. Plans who optimize see significant savings without making substantial tradeoffs for their members.

In 2020, the average annual premium for family coverage was $21,342, an increase of 55% since 2010 and 22% since 2015.1

An Optimized Pharmacy Network Delivers

A more efficient mix of network size, savings and quality.

Pharmacy locations to fill 30- and 90-day medications – all within 5 miles of 98% of members.

Extra care for chronic and costly conditions from specialized pharmacists.

Member engagement tools, clearly outlining member choice and savings opportunities.

The Choice And The Savings Are Yours

Our three bundles are options for a holistic network management strategy.
Click each bar to preview their features, savings and access.

  • Gold Plan Information


    Our best option, the Gold bundle offers the most savings for plans, while still providing members with access to nearly all pharmacies in the nation. And, they’ll be 19%1 more adherent to their medication regime.


    The Gold bundle offers plan savings of up to $73 PMPY3.


    With Gold tier bundles, your members choose from practically any pharmacy in the nation to fill their short-term medications, but pay as much as $10 less when they use conveniently-located preferred pharmacies. Express Scripts® Pharmacy and select retailers also fill maintenance medications.

    Click here to download a PDF for more information on the bundles and the ONE Method.

  • Silver Plan Information


    Our next option is the Silver bundle, offering the choice to manage the 30-day side of the network, the 90-day side of the network, or all aspects to ensure a holistic network.


    The Silver bundle offer plan savings of up to $34 PMPY3.


    With the Silver bundle, members choose from thousands of pharmacies to fill their short-term medications, but pay as much as $10 less when they use conveniently-located preferred pharmacies. Express Scripts Pharmacy and select retailers also fill maintenance medications.

    Click here to download a PDF for more information on the bundles and the ONE Method.

  • Bronze Plan Information


    The most flexible of our three options, the Bronze bundle is a great first step forward in more closely managing your network, where you'll start to see some savings of a more holistic strategy.


    The Bronze bundle offers savings of up to $11 PMPY3.


    With the Bronze bundle, members choose from thousands of pharmacies for all medication prescriptions, and depending on your goals, can pick up maintenance medications monthly or get their medications delivered every three months.

    Click here to download a PDF for more information on the bundles and the ONE Method.

Click here to download a PDF for more information on the bundles and the ONE Method.

Don’t Compromise Your Benefit

You're constantly challenged to deliver high-quality care at a great value. But budget limitations force HR and benefits professionals to make tough decisions. Luckily, this isn't one of those.

Optimized networks deliver real savings you can instantly reinvest in any other part of your benefit. Making one pharmacy network change now is significantly less disruptive than making tough changes later – like cutting benefits programs or raising employee premiums.

The average annual employee deductible has increased 25% over the last five years and 79% over the last ten years.4

Keep the pharmacy, without compromise or cost.

Don’t hesitate to optimize your network because of the perception that the math won’t add up. Thanks to enhancements we’ve made to our network options, the savings are substantial, the change is minimal and the value return is instant and sustainable. Avoiding this small change now could prevent you from seizing even greater opportunities in the future: What causes more disruption than continuously increasing premiums or member cost share?

Did you know:
Most networks allow members to go anywhere, they may just pay as little as $5 more?

A Seamless Solution

Perception vs. Problem

With the ONE Method, we've seen first-hand that disruption is more of a perception than a problem. Hundreds of clients have moved to a preferred network structure with minimal compromise of member access. It's not about making big changes, it's about making the right choice.

More Choices Than You Think

Maintain your current broad network with member access to 65,000 pharmacies and a preferred network of 35,000 – that's more than the leading U.S. fast food and coffee chains combined.

Preferred pharmacies
filling acute meds:

Leading fast food
chain locations:

Leading coffee
chain locations:

It’s not disruption.
It’s progress.

Hear more about how we're optimizing our network strategy for clients just like you.

It’s savings you can reinvest.

Successful pharmacy changes are possible, giving clients more room in their benefits budget.

Proof That Optimization Works

Successful pharmacy network optimizations drive savings and avoid serious disruption. Clients like you are seeing undeniable results. Don’t miss out on real dollars that help preserve your benefit budget for all your employees just to avoid a small, short‑term change for a few.

  • Express Scripts PBM Employer Client Example

    • Implemented a 90-day benefit for maintenance medications, including specialization in diabetes management, to save money without significantly impacting 20,000 member base.
    • Added a preferred 30-day network for acute medications.
    • Resulted in $1.5M savings, plus 90-day utilization increased to 72%, leading to improved adherence.

    When we adopted an exclusive home delivery program, we were able to use the additional savings to keep premiums almost flat for the last nine years. The value of keeping benefit cost share stable for our workers was well worth the changes they went through.”

    - Current Express Scripts client, mid-size regional manufacturing company
  • Express Scripts PBM Health Plan Client Example

    • Implemented a preferred-value network strategy initially with a subset of population; continued to add lives over three years.
    • Leveraged integrated communication strategy and community outreach events.
    • Resulted in zero member complaints.

    We partnered with Express Scripts on enhancing the Medicare preferred pharmacy network over 3 years. As a result, we effectively doubled the number of lives in our preferred network, reduced the number of preferred pharmacies by 10K, and switched the major retail anchor, while experiencing little to no complaints from our members!”

    - Current Express Scripts client, large northeast Health Plan
  • What Others Are Saying

    According to the J.P. Morgan 2019 Pharmacy Study, 75% of clients with a preferred network structure saw little to no member noise around pharmacy access.

A Proven Member Transition Plan

No matter which network optimization strategy you choose, the ONE Method includes a comprehensive communication plan to help members transition to a preferred pharmacy smoothly. Even positive changes bring questions. Our member communications strategy clearly explains what choices members have and where they can go to learn more.

We work with our retail partners to ensure each store is ready and stocked with the medications new members need.

Members can easily transfer a prescription through a quick call to their doctor, their pharmacy, or easily via Express‑ or our mobile app.

Our integrated communications campaign clearly outlines member choice and savings opportunities through phone calls, emails, letters and our website, digital tools and 24/7 contact centers.

Our proven member communications
strategy is informed
by over three decades
of experience.

Learn what optimization can do for your plan.

Learn what optimization can do for your plan.

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