Rx Product Release - Version 4.2 (P) | 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 — along with the introduction of Formulary-EQ, an exciting new feature that models the financial impact of formulary-driven utilization shifts. Read on for everything you need to know about what's changing and what to expect.

Formulary EQ

Formulary-EQ is a new capability that gives you the opportunity to showcase the true value of your formulary management where it matters most — in the numbers. For the first time, your expected formulary shifts can be reflected directly in broker-facing financial analysis, giving brokers a clearer and more accurate picture of what performance under your formulary actually looks like.

Starting with this release, you can upload your formulary alternative lists into Ringmaster today. In the next release, brokers will gain access to the full Formulary-EQ analysis in their Financial Summary — and PBMs who have their lists uploaded and linked to RFP responses will have their formulary strategies reflected in the analysis.

To get set up:

• Navigate to Administration → Organization Details → Formulary EQ
• Click “Create List” and enter a formulary name

• Upload a CSV file with the following four fields:
  • NDC - The target NDC expected to shift to an alternative under your formulary
  • Alternative NDC - The alternative product the target NDC is expected to shift to
  • Weight - When multiple alternatives exist for the same NDC, weight determines which is used in repricing. Enter a numeric value reflecting the relative likelihood of each alternative — the highest weight wins
  • Unit Conversion - A numeric factor used to adjust the metric quantity of the target product to align with the alternative product's metric basis

• Associate bid responses with the stored Formulary EQ lists via the formulary name dropdown in Step 3 of the RFP

One important thing to keep in mind: brokers control how much of the projected formulary impact they apply in their analysis via an optimization slider. The slider defaults to 0%, meaning no formulary impact is applied until the broker actively chooses to adjust it. Uploading your lists and linking them to your RFP responses is what makes that possible — the rest is up to them.

Tiered Rebate Model

Tiered rebate guarantees can now be entered and evaluated directly in Step 3. To submit a tiered rebate bid, follow the steps below:

• In Step 3, select "Tiered" from the Rebate Structure dropdown. The interface will update to display the tiered rebate fields.
• Select the appropriate Guarantee Structure: Flat, % of Brand AWP, or % of Brand WAC.
• If applicable, enter an Additional Rebate Guarantee. This guarantee applies across all rebate-eligible claims on top of the tier-specific guarantees.
• Use the plus and minus buttons to set the appropriate number of rebate tiers.
• Enter the guarantee for each tier.
• Click "Upload Tiered Rebate List" to upload a CSV file containing the rebate-eligible NDCs and their corresponding rebate tier.
• Complete the remaining steps and save your bid

A note on Formulary EQ and tiered rebates: Tiered rebate models are particularly sensitive to drug mix. Because each NDC carries its own rebate tier, shifts in utilization can have a meaningful impact on rebate projections. Linking your Formulary EQ list to your RFP response allows brokers to estimate rebates across the expected drug mix under your formulary — improving the precision of the tiered rebate calculation and giving brokers a more accurate picture of your proposal.

Admin Fee Updates

Admin fees are a core component of contract economics, and Step 2 has been updated to capture them more precisely. New Secondary Admin Fee and Secondary Admin Fee Basis fields have been added to support multi-fee contracts, and both the primary and secondary basis fields now offer the following expanded options:

• Flat Fee
• % of Net Cost (Net Cost = Gross Cost − Member Cost Share − Rebate Guarantees)
• Per Claim
• PEPM
• PMPM

If your contract includes multiple admin fees or a fee type that was previously difficult to capture, review the new options to see if your bids can be better captured.

New Exclusion Toggles

Seven new exclusion toggles have been added across both Step 2 (Discounts) and Step 3 (Rebates), giving you more granular control over which drug categories are included or excluded from the analysis:

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

A few things worth noting. COVID-related claims are no longer treated as a blanket exclusion — they now have individual toggles and will be included in analysis by default unless explicitly excluded. Because COVID claims were previously blanket exclusions, existing responses and rapid quotes have been defaulted to excluded. Review your rapid quote profiles and update them if this does not reflect your intended approach.

HIV PrEP and OTC Devices are subcategory toggles, allowing you to exclude each without removing the broader HIV or device categories from the analysis. For existing responses and rapid quotes, the HIV PrEP toggle has been defaulted to match your existing HIV claims setting, and the OTC Devices toggle has been defaulted to included. Review your rapid quote profiles and update them if either setting does not reflect your intended approach.

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 you to indicate which ones will have rebate credit value applied. This list reflects historical WAC reduction activity and may expand in future releases. WAC reductions not captured in our list can be entered in question 5.

For existing bid submissions, new and updated questions have been flagged as Not Confirmed with a comment indicating they were not present at the time of submission. For rapid quote profiles, responses to new and updated questions have been left blank. Brokers can still run rapid quotes in the interim, but incomplete responses may affect the quality of your submission. Update your rapid quote profiles as soon as possible to ensure your next RFP response is complete and accurate.

Drug-Level Specialty / LDD Discounts 

Specialty and LDD discount guarantees can now be captured at the NDC level. For contracts that apply discounts at the individual drug level rather than at the channel level, you can now upload NDC specific AWP discounts as an optional field within your Specialty and LDD list uploads. When NDC-level discounts are present, they will be applied in repricing. If a channel-level guarantee is also provided, it will take precedence.

If you have existing rapid quote profiles with Specialty or LDD lists, review whether NDC-level discounts apply to your contract and update your uploads accordingly

Formulary Name Field Change

The formulary name field in Step 3 is now a dropdown populated with the formulary names associated with your Formulary EQ lists. You 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.