84-13-16

The Town of Billerica, MA seeks an independent pharmacy‑benefit consulting firm to guide the town through its non‑Medicare prescription drug program. The consultant will develop and manage a competitive Pharmacy Benefit Manager (PBM) procurement, evaluate carve‑in versus carve‑out models, negotiate contracts, perform financial analyses, and provide ongoing claims monitoring, audit, rebate reconciliation, and strategic clinical recommendations. The engagement is for three years, beginning upon award (anticipated Nov 2026) and continuing through the first PBM contract effective July 1 2027 and beyond. • Design, issue, and manage a PBM Request for Proposals, including market research, specifications, and evaluation criteria. • Conduct financial and operational analysis of carve‑in vs. carve‑out models and advise on optimal structure. • Negotiate PBM contract terms, audit performance, reconcile rebates, and deliver ongoing utilization and cost‑containment reporting. • Provide continuous claims review, market monitoring, and clinical strategy support (e.g., specialty drug management, formulary design). • Supply regular reports and participate in Town/Hilb meetings; optional finalist interviews may be conducted.