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Board designates TrueScripts as PBM and adopts four-tier pharmacy plan with caps on specialty costs
Summary
The board approved a new pharmacy benefit program that designates TrueScripts as the district's pharmacy benefit manager effective Jan. 1, 2027, moves to a four-tier copay structure separating specialty drugs, and sets per-prescription coinsurance and maximums intended to protect employees while controlling costs driven by a small number of high-priced specialty fills.
The West Bend School District board voted July 27 to designate TrueScripts as the district's pharmacy benefit manager and to adopt a modernized four-tier copay structure that separates specialty medications and establishes coinsurance with per-prescription maximums.
Assistant to the superintendent Lenny Hansen told the board the administration recommends selecting TrueScripts after an RFP and reference checks that emphasized stronger customer service and cost-control programs. "We recommend that the board designate TrueScripts as our pharmacy benefit manager effective January 2027," Hansen said. He stressed that a definitive services agreement will be returned to the board once contract terms are finalized.
The administration recommended a four-tier structure (generic, preferred brand, nonpreferred brand, specialty) with generics unchanged at a $10 flat copay and an 80% district / 20% employee coinsurance approach for tiers 2'4 with per-prescription maximums: preferred brand up to $60, nonpreferred up to $90, and specialty up to $120 per fill. Hansen said generics account for roughly 88% of fills and that specialty drugs account for about 1% of fills but approximately 43% of prescription drug costs on the plan; he noted the average specialty drug fill on the district plan in 2025 was roughly $9,100. The board adopted the resolutions for plan design and to designate TrueScripts by voice vote.
