
Common Questions
GLP‑1 medications are one of the fastest‑growing drivers of pharmacy spend for self-funded and public sector plans, so sponsors want to understand how coverage decisions are made. A health‑system–owned PBM evaluates GLP‑1s using evidence-based criteria, total cost‑of‑care impact, and responsible utilization management to support sustainable coverage without unnecessary member burden.
Legislation is rapidly changing, and ClearScript is watching. Follow ClearScript’s LinkedIn page or check out our Insights page for resources and news on current pharmacy benefit regulations.
TPAs should look for PBM transparency measures such as full audit rights, clear access to claims and rebate data, and complete disclosure of all revenue streams—including administrative fees, spread, and manufacturer-derived payments. A transparent PBM also provides pass-through pricing, detailed reporting, predictable contract terms, and open visibility into formulary decisions, ensuring TPAs can confidently support plan sponsors and protect their financial interests.
Get a free assessment
Call (612) 672-6500 or 866-718-2845 or complete this form and we’ll follow up.
Our assessment program analyzes your healthcare plan’s existing pharmacy benefit program and pinpoints the savings opportunities.
"*" indicates required fields
