RxBenefits Protecting Union Pharmacy Benefits with Transparency + Trust

In this episode of the Union Labor Advisory Network, Mike Fina sits down with RxBenefits’ dedicated labor team—Gregg McAndrews (Strategic Account Executive) and Faiq Gasi (Clinical Pharmacist Consultant)—for a clear, practical conversation about one of the biggest and most complex costs in union healthcare: prescription drugs.

RxBenefits explains how they support Taft-Hartley and self-funded union health funds by serving as a Pharmacy Benefit Optimizer (PBO)—meaning they are not a PBM, but instead work on behalf of the fund and its members to ensure pharmacy dollars are spent wisely, benefits are protected, and members receive real support when they need it most.

What Makes RxBenefits Different for Union Funds

The team highlights a core issue in today’s pharmacy system: traditional PBM incentives often reward higher-cost drugs, driven by rebates, spread pricing, and profits tied to medication selection. RxBenefits positions itself as an independent advocate—focused on:

• Full transparency into drug costs and plan performance
• Independent clinical oversight led by pharmacists (not PBM-employed decision makers)
• Ongoing claims data analysis to uncover waste, improve coverage decisions, and protect the fund
• Member-first support with “white glove” service and real people answering calls in the U.S.

Independent Clinical Management That Protects Members and the Fund

Faiq shares the value of pharmacist-led decision-making versus automated systems that may prioritize PBM economics. RxBenefits’ clinical team evaluates medications through two critical lenses:

• Is it clinically appropriate and safe for the member?
• Is the fund paying more than it should for the same outcome?

They discuss real-world scenarios where members are often prescribed higher-cost brand drugs—even when lower-cost options like generics or biosimilars provide the same clinical value—saving members hundreds per year while protecting the fund from unnecessary spend.

Member Experience: Dedicated, Human Support

Gregg emphasizes that RxBenefits’ approach is built for union environments—where trust, relationships, and responsiveness matter. Instead of members navigating automated systems, RXBenefits focuses on:

• U.S.-based member services
• Problem resolution driven by accuracy—not rushed call times
• Reducing member frustration at the pharmacy counter
• Preventing escalations that fall back on fund offices

Big Future Opportunities: Biosimilars, GLP-1 Management & Real Transparency

The episode also looks ahead at major trends shaping union pharmacy costs, including:

• Biosimilars as the next wave of savings in specialty drugs—similar to how generics transformed brand drug spending
• GLP-1 medications, and the importance of proper eligibility, prior authorization, and structured support programs
• RxBenefits’ launch of a transparent PBM option, Illuminate Rx, designed to move away from rebate-driven models and deliver the lowest net cost upfront—helping funds avoid “pay now, get money back later” pricing

Key Message for Union Leaders and Trustees

RxBenefits encourages union trustees, administrators, and consultants to begin with a claims analysis—leveraging a fund’s existing data to uncover savings opportunities, ensure clinical integrity, and evaluate whether their model is the right fit.

The underlying message is simple—and aligned with union values:

Partners should stand on the side of the member—protecting care, protecting benefits, and protecting the fund’s long-term sustainability.

Closing Takeaway

This conversation reinforces why pharmacy benefits are critical to the union workforce. When plans eliminate waste and improve transparency, funds are better positioned to preserve strong benefits, maintain stable co-pays, and ensure long-term security for working families.

To learn more Visit: https://www.rxbenefits.com/who-we-serve/labor-and-trust/

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