Frequently Asked Questions

The Pharmacy Stewardship Program™ is Limitless Consulting’s flagship initiative to correct pharmacy waste for self-funded employers. It focuses on optimized sourcing, identifying the 1 to 2% of medications that drive the majority of prescription spend, and finding the lowest legal and compliant cost to obtain them. 

Limitless is at the forefront of emerging legislation and programs designed to help employers save money on prescription medications. With contracts in place with nearly every major sourcing vendor, Limitless can offer nationally negotiated rates and secure competitive bids on behalf of each client.

In practice, the program reclaims 50 to 80% of the unnecessary spend on high-cost medications while maintaining complete compliance and zero disruption to existing PBMs, carriers, or provider networks.

Yes. Our program operates fully under federal law (21 USC §384), which allows personal importation of prescription drugs from Tier-1 countries under specific safety and quantity rules. All drugs come from licensed international pharmacies or directly from manufacturers; same product, same factory, lower cost. Ask for our White Paper for more information on state and federal law.

Some of them, yes. However, rebates are a small fraction of potential savings. This program targets high-cost drugs that drive 40% of spend, replacing them with lower-cost alternatives. Our analysis always prices in rebate loses. One recent case study showed after losing $305,000 in rebates, one group saved nearly $1 million in net savings. Without exception, our savings outperform rebate strategies.

No. This is not insurance. It is a pharmacy optimization and concierge service designed to reduce waste and deliver the same medications at lower cost. It works alongside your existing plan, PBM, and providers without disruption.

No. The program runs independently as a concierge service. All outreach, coordination, and logistics are handled for you. No new hires, no extra workload, no added expense.

No. On the contrary. This is both a cost-saving service and a white glove employee benefit. Employees get the same medication at their door (same as before), but for free. It lifts the financial burden and frees them from the stress of unaffordable prescription.

Our model reduces the profits of entrenched players in the current system. Pharmacy benefit managers, carriers, and wholesalers make billions from inflated drug pricing and rebate structures. This program bypasses those middlemen and redirects the savings back to employers and employees. It’s legal, it’s proven, and it’s time.

 That response is common, but often misleading. Some PBMs, carriers, or consultants raise concerns not because the program is illegal, but because it challenges their existing revenue models. These are business objections, not legal ones.

If you are self-insured, implementing this strategy is entirely at your discretion. You are not bound to your PBM’s opinion or pricing model when offering compliant options outside their network. This program does not require PBM or carrier approval and has no impact on your existing plan design, formulary, or network.

It simply gives your members a legal, optional path to access select high-cost medications at a fraction of the domestic price.

TrumpRx is currently structured as a direct to consumer cash program, not something employers can natively plug into their health plans. There are still many unknowns about how it will ultimately be implemented and scaled, but Limitless is already at the forefront of exploring how to integrate TrumpRx pricing alongside other Most Favored Nation level sourcing pathways into employer plans. Through our Pharmacy Stewardship Program, we are preparing the framework so that when TrumpRx matures, self funded employers can capture those savings seamlessly, with Limitless as the trusted partner ensuring compliance, employee access, and maximum savings. 

To perform a savings analysis we only need a standard 12-month pharmacy claims file that is already available from your PBM. This file is de-identified and does not contain personal health information. It shows the drug name, quantity, and cost... nothing more. Data is transferred securely using encrypted channels, and our team handles the entire setup process so there is no added burden on your IT or HR staff. The process is simple, fast, and fully compliant with federal privacy and security requirements.

The pharmacy market is evolving quickly, with new direct-to-consumer and manufacturer-sponsored programs entering the space. Employers should not have to chase these opportunities on their own. Limitless monitors, validates, and integrates new pathways as they become available, ensuring that our clients are always capturing the best prices in a compliant and seamless way. Whether it is TrumpRx or other Most Favored Nation style initiatives, our role is to stay at the forefront and bring those options into your plan so that you do not miss out on future savings. 

Employers lower healthcare costs by targeting the small number of claims that drive the majority of spend rather than reducing benefits across the board. For self-funded plans, pharmacy costs represent the most immediate and controllable opportunity. Addressing high-cost prescriptions directly can reduce overall healthcare spend by 10 to 15% without changing coverage, providers, or networks. This is the purpose of our Pharmacy Stewardship Program™.

The primary driver of rising employer healthcare costs is pharmacy spend, not utilization. Specialty medications and biologics now account for a disproportionate share of total plan costs, often driven by pricing mechanics rather than clinical necessity. Administrative complexity, rebate structures, and opaque pricing models further accelerate year-over-year increases. 

The biggest opportunity is pharmacy spend, particularly the 1 to 2% of medications that drive 40 to 60% of total prescription costs. Medical costs are difficult to influence without network disruption, but pharmacy costs can often be reduced materially through compliant sourcing and optimization strategies that operate outside the core insurance contract. 

Most self-funded employers can expect to save approximately $1 million to $1.5 million per 1,000 employees annually when high-cost pharmacy waste is addressed. These savings are net of rebates and do not require benefit reductions or vendor replacement. Actual results depend on plan size, utilization, and drug mix. 

Yes. Pharmacy cost reduction strategies through our Pharmacy Stewardship Program™ can  be implemented any time because they operate independently of insurance renewals. Employers do not need to wait for carrier negotiations or plan redesigns to begin reducing pharmacy spend. 

Most traditional strategies focus on cost shifting rather than cost reduction. Higher deductibles, narrower networks, and formulary restrictions often reduce employer liability while increasing employee burden. These approaches do not address the underlying pricing inefficiencies driving pharmacy costs and often create dissatisfaction without meaningful long-term savings. 

This approach is most effective for self-funded employers of all sizes, where pharmacy utilization patterns create meaningful savings opportunities. Smaller employers may still benefit, but results scale with population size and the presence of high-cost specialty medications. We're happy to provide case studies of employers of a similar size and industry so you can know what to reasonably expect for an outcome.

Savings begin immediately after implementation. Unlike multi-year cost-containment strategies, pharmacy optimization delivers measurable impact quickly. 

Because healthcare spend is highly concentrated. A small percentage of prescriptions drive the majority of pharmacy costs, while the remaining prescriptions contribute little to overall spend. Targeting the cost drivers produces meaningful savings without disrupting the broader plan or member experience.