U.S. pharma spend audited by ZeroPBM: 1.1376584172%

Are you overpaying for your employees' prescriptions?

Statistically, yes. Most plans are marked up 15–25%.
Legally, it's now your problem — under the Consolidated Appropriations Act, you have a fiduciary duty to stop it.

Trusted by leading employers
The Problem

Your PBM keeps the difference.

What the drug actually costs $12
What your PBM charges you $47
Per employee, per year $4,200

They buy your employees' drugs cheap and bill you full price — exposed by the FTC, the New York Times, and Congress. For a 500-person company, that's over $2 million in hidden markups a year — and employers who don't audit can be held legally responsible.

The Output

This is what you get.

A line-by-line audit showing which drugs were overpriced, by how much, and what you can recover. Every figure benchmarked against federal NADAC data.

  • Board-ready recovery estimate A clear bottom-line number, not just raw claims noise.
  • Line-item evidence trail Every flagged claim is tied back to the underlying benchmark and fill date.
  • Negotiation-ready output The report is designed to support PBM escalation, contract review, and broker conversations.
Request a redacted sample report
ZeroPBM Audit Report
Powered by the ZeroPBM Engine
Three layers of analysis. One clear number.
150M+
ZeroPBM Index

Automated data ingestion, parsing, and indexing across 150M+ NADAC, CMS, and WAC records — enriched with historical case data to build a proprietary pricing benchmark.

Forensics Core™

AI-driven analysis trained on thousands of past cases, detecting spread anomalies, pricing outliers, and contract violations at scale.

$
Recovery Report

Fully cited, board-ready dossier with line-by-line variance, projected recovery, and a legal-grade evidence trail.

450 employees. 12 months. $142K recovered.

This chart shows a real audit outcome in simplified form. You do not need to hover to read the story: most spend was fair value, but one material slice represented recoverable PBM overcharges.

Fair value spend $508K of the annual pharmacy spend aligned with benchmarked pricing and did not require action.
Recoverable overcharge $142K, or 21.8% of spend, was flagged as excess pricing worth escalating or recovering.
12 mo
Period
450
Employees
5,400
Claims
21.8%
Overcharged
Process

Three steps. That's it.

01

You send us a file

Download your prescription history from your benefits portal and email it to us. No employee names needed — just the drugs, dates, and what you paid.

NDC · Date · Quantity · Pharmacy · Paid Amount
02

Our engine runs the audit

Your claims are cross-referenced against 1.5 million federal drug price records. Every drug, every date, every pharmacy — flagged automatically.

03

You see the numbers

Within 48 hours, you get a clear report showing exactly which drugs were overpriced, by how much, and what you can do about it.

Three ways to start

Pick one.

Verify

See if your PBM is overcharging you. No commitment.

Get started for free →
What you get
  • 500-claim sample audit against NADAC
  • Overcharge dollar estimate
  • Top 5 overcharge categories identified

Audit

The forensic audit. Find every dollar your PBM overcharged you — in 30 days.

Talk to us →
What you get
  • 100% of pharmacy claims re-priced vs. federal NADAC benchmark
  • Up to 3 years of historical claim review
  • ERISA-attorney-signed fiduciary defense memo
  • Pharmacist-signed audit findings
  • Recovery plan with specific dollar amounts per claim
  • PBM negotiation support during recovery
  • Litigation expert witness if disputes arise
  • BAA + HIPAA-compliant data handling

Guard

Continuous oversight. Keep your PBM honest, year after year.

Talk to us →
Everything in Audit, plus
  • Annual re-audit with refreshed fiduciary memo
  • Quarterly performance reports
  • Live PBM-vs-NADAC monitoring dashboard
  • Named account manager
  • Direct PBM dispute representation
  • Regulatory bulletins (CAA, DOL, court rulings)
  • Year-round fiduciary documentation file
  • Year-end board summary report
  • Multi-plan management for parent companies
  • Priority access to expert witnesses
The Evidence

This isn't our opinion. It's the public record.

“…employer health plans pay inflated prices to pharmacy benefit managers… for drugs that cost a fraction of what they're charged.”
Reuters, February 2024
★★★★★
“The audit report made it crystal clear — line by line, drug by drug. We renegotiated our contract within a month.”
ZeroPBM client
Mark Cuban
Mark Cuban
Cost Plus Drugs / Forbes
“Most CEOs don't fully understand that drug rebates come at the expense of higher prices for their employees… a practice that can violate fiduciary duties under ERISA.”
“P.B.M.s often charge employers multiple times the wholesale price of a drug, keeping most of the difference…”
Investigation, June 2024
★★★★★
“I've been in HR for 20 years and never once questioned our PBM pricing. This should be mandatory for every self-insured employer.”
ZeroPBM client
“OptumRx… Express Scripts… CVS Caremark… have pocketed an extra $7.3 billion over cost… due to price gouging of employers.”
Federal Trade Commission
via Forbes, 2024
Customer story

Trusted to recover what self-insured employers have lost.

Air Products recovers $3.9M with ZeroPBM.

Aerial view of a corporate campus parking lot at dawn — hundreds of cars in tight rows, one cyan-blue car parked at the center, a modernist glass-walled headquarters in the distance.
$3.9M recovered in the first 12-month audit cycle
21.8% of pharmacy spend flagged as PBM overcharge
Products used Forensics Core, Recovery Report
Aerial view of a hospital complex at dawn — a row of loading bay doors along the building, a circular helipad with white cross marking, one cyan-blue bay door standing out from the rest.
$840K overcharge surfaced in initial pricing review
18.2% of pharmacy spend flagged for recovery
Products used Forensics Core
Aerial view of a classical university quad at golden hour — symmetrical brick walkways crossing a manicured lawn, a stone library at the far end with one window glowing cyan-blue.
$1.27M overcharge documented across employee plans
23.1% of pharmacy spend flagged in line-by-line audit
Products used Forensics Core, Recovery Report
Aerial view of a factory loading dock at dawn — rows of semi-trailers backed up to a long warehouse wall, one cyan-blue trailer standing out in the middle of the row.
19.4% reduction in annual pharmacy spend
$640K recovered in retroactive overcharges
Products used Forensics Core, Recovery Report
Common Questions

Before you ask

Is my data safe?

We only need de-identified claims data — no employee names, no member IDs. Your IT team can strip those columns before sending. We also sign a BAA on request.

What does this cost?

Nothing upfront. We work on contingency: a percentage of the savings we identify. If we find nothing, you pay zero.

What if you don't find anything?

Then you have written confirmation that your PBM pricing is fair — which is valuable in itself. You owe us nothing.

Am I legally required to audit my PBM?

Under the Consolidated Appropriations Act (2021), self-insured employers have a fiduciary obligation to ensure pharmacy benefit costs are reasonable. An independent audit is the simplest way to demonstrate compliance.

Find out in 48 hours.

Enter your email. We'll reach out to walk you through the process.

Or email us directly at audit@zeropbm.com