Health Solutions

Prescription drugs

We help navigate pharmacy benefit challenges

Dramatic advances in prescription drugs have the potential to improve and save lives—but these improvements come at a cost. Milliman can help you address the full spectrum of pharmacy benefit challenges, from pharmacy benefit manager (PBM) selection to plan design to Medicare Part D consulting, our experienced experts and smart technology are here for you.

Overview

Milliman prescription drugs solutions

PBM contracting and management

Get favorable contracts and better pricing by leveraging our expertise and understanding of the pharmacy benefits market. We assist with the entire PBM lifecycle, including RFPs, implementation oversight, ongoing support, and audits.

Pharmacy plan design

Gain flexibility for your organization and your members with an effective pharmacy benefits plan model. Our rich data and powerful analytic tools help identify the best strategy for your goals.

Medicare Part D

Building effective Medicare Part D offerings requires a thorough understanding of your options and the complex regulations involved. From plan design to formulary review, compliance planning to star rating improvement, Milliman has market-leading expertise in all things Medicare and can help you with any challenge.

Man preparing to use an auto injector syringe at a table.

Drug costs

GLP-1 medications

With benefits far beyond weight loss, patient uptake of GLP-1s is rising. Milliman is analyzing the impact across the healthcare ecosystem to help payers, life sciences companies, and other stakeholders adapt.

Read our research

Insight

Milliman prescription drugs insight

White paper

Approaches to lower Medicare Part D out-of-pocket costs for beneficiaries with limited income

With the sunset of two Medicare demonstration programs, states and Part D plans need to evaluate other strategies to lower cost sharing for affected individuals.

Read the article

Newsletter

Pharmacy Briefing - March 2026

We highlight the latest pharmacy industry news, trends, and insights.

Read the article

Article

From ASP to WAC: 8 key drug pricing terms life science companies should know

We review some commonly used drug-pricing terms in the U.S. pharmaceutical market, including their calculations and roles in the healthcare industry.

Read the article

White paper

Milliman MedIntel Part D trend insights Q3 2025

Drug costs are still rising, but trends begin to slow in Q3 2025

Read the article

White paper

Navigating Medicare Part D settlements post-IRA: Strategic guidance for health plans

Practical considerations for financial forecasting

Read the article

Article

Adapting to the IRA: 5 manufacturer considerations for Part D formulary access negotiations

We discuss five key considerations for manufacturers negotiating Medicare Part D formulary access in the wake of the Inflation Reduction Act.

Read the article

Article

The Medicare Prescription Payment Plan: Implementation in 2025 and implications for 2026

We discuss the implementation of the Medicare Prescription Payment Plan in 2025 and note some implications for 2026.

Read the article

Briefing note

340B Rebate Model Pilot Program—Medicaid implications and considerations

What state Medicaid programs should know and do ahead of the January 2026 launch

Read the article

White paper

Milliman MedIntel Part D trend insights

Utilization trends for non-low income Part D members show no signs of slowing in the first half of 2025

Read the article

Article

Beyond FDA approval: 5 factors in clinical trial design that influence health insurance coverage decisions

We detail factors in Phase-3 clinical trial design that influence health insurance coverage decisions.

Read the article

Milliman prescription drug products

Procurement management

Milliman Payer Network Check

Make high-quality financial comparisons of provider medical reimbursement rates across large insurance carriers.

Learn more

Pharmaceutical claims analytics

MyRxConsultant

Compare contracted discount rates and savings with real-time pharmaceutical claims experience reporting.

Learn more

Insurance risk assessment

IntelliScript

IntelliScript combines industry-leading data and analysis to provide insurers the knowledge, tools, and insight to confidently assess risk.

Learn more

Medicare plan selection solution

Medicare Suggest

Deliver detailed, personalized Medicare plan price comparisons through a simple, web or API experience.

Learn more

Cost-saving analysis

Milliman Specialty Pharmacy Insights

Identify opportunities to manage specialty pharmacy costs for existing and new drug therapies.

Learn more

Price transparency analytics

Milliman Price Transparency Solutions for Payers and Providers

Demystify payer and provider contract pricing data for better transparency across the industry.

Learn more

Healthcare market analysis

Milliman DNA Gene and Cell Therapy Forecasting

Analyze the emerging market to support underwriting, pricing, and product development.

Learn more

Prescription drugs