Rx Product Release - Version 4.2 (B) | April 2026

Overview

Version 4.2 is a significant release for Ringmaster Rx. It delivers a meaningful set of RFP enhancements — including a new tiered rebate model, updated admin fee options, expanded exclusion toggles, a reorganized clinical section, drug level specialty / LDD discounts — and lays the groundwork for Formulary-EQ, an exciting new feature coming in the next release. Formulary-EQ will give you a clearer, more accurate picture of the true financial impact of formulary differences across competing PBM proposals. Read on for everything you need to know about what's changing and what to expect.

Tiered Rebate Model

Tiered rebate contracts are becoming more common in the market, and Step 3 now supports them. PBMs can select "Tiered" as a rebate structure option, enabling tiered guarantees to be modeled directly in the platform without manual workarounds. The interface dynamically updates to capture tier-specific guarantees across a variable number of tiers, an additional guarantee that applies across all tiers, and an NDC list upload that maps each drug to its corresponding tier.

Admin Fee Updates

Admin fees are a core component of PBM contract economics, and Step 2 has been updated to capture them more precisely. New Secondary Admin Fee and Secondary Admin Fee Basis fields support multi-fee contracts, and both the primary and secondary basis fields now offer expanded options: Flat Fee, % of Net Cost, Per Claim, PEPM, and PMPM. The result is greater accuracy when entering incumbent fees and reviewing PBM bids.

New Exclusion Toggles

Seven new exclusion toggles have been added to both Step 2 (Discounts) and Step 3 (Rebates):

• AB-Rated Products
• COVID Antivirals,
• COVID Tests
• COVID Vaccines
• HIV PrEP
• OTC Devices
• Synthroid.

COVID-related claims are no longer blanket exclusions and know have specific granular controls. Be aware that this change may marginally increase the gross drug cost in some analysis outputs.

Together, these toggles give you a more precise and accurate picture of both incumbent contracts and PBM bids.

Clinical Question Updates

Step 6 has been reorganized with some of the existing Formulary Management questions being redistributed and new questions added across two new subsections. 

Formulary Management - Streamlined from 13 questions to 8 questions with selected questions redistirbuted into the newly created Low Cost Alternatives and WAC Reductions subsections. The remaining 8 questions are unaltered and all previously entered responses will persist.

Low Cost Alternatives - A new dedicated section with 8 questions total. Questions 1–4 are new and address how rebate credit values are applied for low cost alternative switches. Questions 5–8 are relocated from the former Formulary Management section, with Questions 6 and 8 carrying updated wording to reflect the more common approach for capping rebate credit values.

WAC Reductions - A new dedicated section with 5 entirely new questions. Question 4 is notably interactive — it presents a multi-select list of drugs known to have had WAC reductions over the past three years, and requires the PBM to indicate which ones will have rebate credit value applied. This list reflects historical WAC reduction activity and may expand in future releases.

Drug-Level Specialty / LDD Discounts 

Specialty and LDD discount guarantees can now be captured at the NDC level. For contracts structured around drug-specific discounts rather than aggregate channel-level guarantees, you can now upload NDC-level discounts directly as part of your Specialty and LDD list uploads. When present, NDC-level discounts will be used in repricing — though if channel-level guarantees are also provided, they will take precedence.

Formulary Name Field Change

The formulary name field in Step 3 is now a dropdown populated with the formulary names associated with the PBM’s Formulary EQ lists (see below). PBMs can still select “Other” and manually enter a name if a listing has not been stored. All existing responses are categorized as "Other" until someone manually changes the response to an associated Formulary EQ list.