Hillsborough County staff and outside consultants on June 18 presented an analysis of the county’s prescription drug program and a planned transition to a pass-through pharmacy benefit manager (PBM) pricing model beginning in 2026.

Consultants from the Baldwin Group and Prism Health Group explained the current spread- or “traditional” model limits visibility into underlying drug prices and PBM revenues. Nick Getz of the Baldwin Group used an “iceberg” analogy to describe the change: under the new model, “you have full transparency, full clarity, and full visibility into your program, the financial results of the program, and the actual cost of drugs.”

Ryan Rice, president and CEO of Prism Health Group, who conducted an independent analysis, told the board the forthcoming 2026 contract—structured as a fully pass-through, transparent PBM arrangement—would be “approximately 25% better than what you have in place today” and “result in a cost savings of approximately $7,000,000 to the county, the employees, and their families.” The consultants said beneficiaries should also see lower out-of-pocket costs at the pharmacy because discounts and pass-through savings will reach the point of sale.

Commissioner Wolstiel, who had requested the analysis, said the contract negotiation and vendor disclosures had revealed “massive upcharges” and welcomed further work to protect employees and taxpayers. Several commissioners urged continuing oversight and follow-up reporting after the contract starts; Commissioner Miller asked that staff return with longer-term results once the pricing is in place.

Staff recommended proceeding toward the transparent model; the board received the report unanimously and directed staff to continue monitoring implementation and report back with actual performance data once the contract is in effect.