The major hurdle for employer pharmacy plans is the lack of collaboration and transparency with Pharmacy Benefit Managers (PBMs), which impacts costs and outcomes. Traditional PBM structures may limit transparency into acquisition costs and rebate flows, and other savings opportunities such as patient assistance and coupon programs are also muddled. This often eliminates the lowest-cost drugs or acquisition methods because of the elimination of margin. The greatest example of this is in the acquisition of specialty drugs. 1% to 5% of patients can account for 50% or more of pharmacy costs*, particularly with specialty drugs