Independent PBM Contract Auditing — Recover What's Yours.
Expert third-party auditors specializing in Pharmacy Benefit Manager contracts. We verify pricing, rebates, guarantees, and performance so plan sponsors, employers, and health plans get what they negotiated.
5–15%
average savings on pharmacy spend
100%
independent — no PBM affiliations
$2.8M
recovered for a single client in one audit
What we deliver
PBMs manage billions in drug spend, but complexities in pricing, rebates, and guarantees often result in significant leakage. Regular independent audits protect your plan and members.
Recover Overpayments
Identify and reclaim discrepancies in pricing, rebates, and adjudication errors.
Full Transparency
Independent, unbiased review of PBM performance with no manufacturer affiliations.
Risk Reduction
Ensure regulatory and contractual compliance across your entire pharmacy benefit.
Proven Results
Average 5–15% savings on pharmacy spend for our clients.
Comprehensive PBM audit services
Five core service lines, each delivering an executive summary, detailed findings report, financial impact analysis, and recovery recommendations.
Full Claims Audit
Recover overcharges and adjudication errors across 100% of your pharmacy claims — or a statistically significant sample. We verify AWP discounts, MAC pricing, dispensing fees, and ingredient costs.
Learn more →Rebate & Revenue Audit
Validate manufacturer rebate pass-throughs and reconcile DIR fees, administrative fees, and revenue streams.
Learn more →Contract Compliance Review
Detailed gap analysis of your PBM master services agreement against actual performance.
Learn more →Specialty & Operational Audits
Specialty pharmacy pricing, formulary management, PDE data validation, EGWP and RDS audits.
Learn more →Ongoing Monitoring & RFP Support
Annual audit programs, PBM request for proposal assistance, and contract negotiation support.
Learn more →Our commitment
100% Independent — no affiliations with PBMs or manufacturers.
We don't just find issues — we help you recover funds. Data-driven, custom audit protocols tailored to your contract language and plan design.
Get a Free ConsultationThe hidden cost of unaudited PBM contracts
PBMs manage billions in drug spend. Complexities in pricing, rebates, and performance guarantees often result in significant financial leakage that goes undetected without an independent audit.
Ensure fiduciary responsibility to your members
Recover overcharges and enforce guarantees
Combat spread pricing and opaque PBM practices
Stay ahead of regulatory scrutiny
Achieve better outcomes in future negotiations
Ready to take control of your pharmacy benefits?
Schedule a free consultation with our team. We'll review your situation and show you exactly where leakage is likely occurring.