A self-funded pharmacy benefit plan is a model in which a group (e.g. employer, trust fund, etc.) pays directly for a member’s (e.g. employees, members, etc.) prescription drug claims. This structure gives groups greater control over plan design, pricing transparency, and pharmacy cost management.

Self-funding a health plan gives groups greater control over their pharmacy and medical benefit costs. Instead of paying a premium to a fully insured plan, groups pay for actual claims, which allows them to: Reduce overall costs: eliminate insurer profit margins and leverage cost-containment strategies. Customize benefits: tailor pharmacy plans that maximize a member’s benefits at a substantial discount to the group. Access data: use claims and utilization data for informed decision-making. Retain unused funds: Savings remain with the group instead of going to an insurer.

We are a boutique pharmacy benefit administrator (PBA) focused on reducing self-funded groups’ pharmacy spend through a combination of innovative programs designed around net savings. 3rd Gen Rx does not chase discounts or rebates. We chase true savings to the plan. Leveraging over 50 years of combined experience in employee benefits, pharmacy, and health insurance, 3rd Gen Rx was founded on the principle of eliminating waste, fraud, and abuse from the pharmacy benefit, with the goal of delivering true net plan savings to groups while maintaining the member benefit. We do not save a group money by simply shifting the cost to the plan member. We use innovative programs to allow the member to get a medication at a reduced cost to the group and frequently, a reduced cost to the member.

Many traditional PBM models focus on rebates and complex pricing structures that do not result in the lowest net cost for groups. By evaluating alternative pharmacy strategies through our unique Cost Reduction Marketplace offering, 3rd Gen Rx can identify solutions that produce substantial cost savings. These programs reduce group spend while maintaining member access to medications.

3rd Gen Rx helps self-funded groups reduce pharmacy benefit costs by analyzing their daily pharmacy spend to identify savings opportunities through the Cost Reduction Marketplace. By comparing multiple pharmacy strategies and focusing on net plan cost, 3rd Gen Rx implements solutions that significantly lower prescription drug spend.

The Cost Reduction Marketplace is a set of pharmacy saving programs designed to help self-funded groups reduce prescription drug spend. It includes 6 unique programs specifically designed to lower the cost of generic, brand, and specialty medications. By evaluating multiple pharmacy strategies within the marketplace, we help identify the solution that produces the greatest net plan savings while maintaining member access to medications.

The Cost Reduction Marketplace is designed to reduce the plan cost of generic, brand and specialty medications.

Savings vary depending on the group’s current pharmacy benefit structure and medication utilization. To date, groups that partner with 3rd Gen Rx have experienced more than 30% net plan savings on average during the first year.

No. The Cost Reduction Marketplace is designed to reduce unnecessary plan spend while maintaining or improving member access to medications. The objective is to deliver group savings while preserving a positive member experience.