Rightway Eliminates Hidden Conflicts and Loopholes of Traditional PBM Pricing with SureSpend™
Traditional PBM models create systematic conflicts of interest that drive up costs through opaque rebate retention and undisclosed discounts, formularies that favor high-rebate drugs over lower-cost alternatives, pharmacy ownership that steers members for additional revenue, and limited year-end reporting that delivers expensive surprises. Meanwhile, PMPM guarantees include exclusion lists that remove entire drug categories, such as vaccines and GLP-1s, from protection, capped refunds that expose clients to unlimited liability, shared savings clauses that allow PBMs to keep a portion of under-budget results, and cost shifting to members that masks true total spending.
Rightway's SureSpend model solves challenges across both approaches, providing the industry's most comprehensive financial protection through its Precision Pricing Guarantee and Zero-Markup Wrap.
"Employers shouldn't have to choose between transparency with loopholes and traditional models with conflicts of interest," said
Rightway makes money through a simple administration fee, not on medications dispensed through the plan. This structural alignment eliminates hidden incentives and drives meaningful accountability toward lower pharmacy costs.
SureSpend's Precision Pricing Guarantee establishes a single, predictable monthly cost with unlimited liability—Rightway refunds 100% of overages dollar-for-dollar with no cap. The Zero-Markup Wrap extends financial protection to drug classes that other PBMs typically exclude entirely, including GLP-1s and rare high-cost medications at true net cost with 100% rebate pass-through.
The model includes both employer and member spending for true total cost accountability, features quarterly reporting and rebate reconciliation for consistent cash flow, and ensures simple reconciliation, with plan sponsors keeping 100% of savings with no shared savings clauses. Rightway's pharmacy team actively guides members to lower-cost, clinically appropriate alternatives through evidence-based interventions, making it possible to meet the guarantee while improving outcomes. Formularies are built around the lowest net cost and clinical appropriateness. With no pharmacy ownership, Rightway avoids the conflicts of interest that plague traditional PBMs.
About Rightway
Rightway is transforming pharmacy benefits and care navigation with a member-first approach that blends expert clinical guidance, high-touch service, and intuitive technology. Rightway delivers personalized, evidence-based support that improves outcomes, drives engagement, and reduces costs. Rightway is the only PBM that integrates pharmacy navigation from clinical experts, guiding members to high-value medications while delivering fully aligned pricing, 100% transparency, and a total spend guarantee. Its care navigation solution simplifies healthcare with proactive, clinician-led support, creating better experiences for members and measurable savings for employers. With Rightway as their healthcare benefits partner, employers don't have to compromise on employee health, happiness, or their company's results. Learn more at www.rightwayhealthcare.com.
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SOURCE Rightway
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