Breaking Down the Pass Through Pricing Model

Express Scripts negotiates with its network of retail pharmacies and other providers to obtain discounts for prescription drugs. In a pass through pricing model, the client chooses to pay the exact discounted value that Express Scripts negotiates.  

Clients elect this option when they prefer maximum cash flow over the set pricing provided in a spread model. Clients then pay directly for the administrative services provided by Express Scripts, including claims adjudication, retail network management, formulary management, clinical programs and utilization management programs. 

The amount of fees is driven by the services and customization Express Scripts provides to clients in a highly competitive marketplace.