Trend EQ Guide

Overview

Trend EQ is a new capability that brings forward-looking trend projection into the pharmacy bid evaluation process. Apply cost and utilization trend assumptions directly to repriced claims and see projected financial results that reflect where pharmacy spend is headed during the future contract period — not just where it has been.

What sets Trend EQ apart is the depth of control it offers. Beyond standard drug category defaults, custom categories can be defined at the guarantee channel, GPI, or NDC level, giving users the ability to apply precise trend assumptions to virtually any segment of their claim population.

Accessing Trend EQ

Trend EQ is accessed from within the standard financial summary workflow. To get started:

• Select the bids you would like to evaluate and click Edit Financial Summary.
• On the Calculate Financial Summary screen, select the date range to use in your analysis as usual.
• In the bottom left corner of the screen, click the Trend EQ button to open the feature.

If you prefer not to apply trend assumptions, you can proceed through the workflow as normal — Trend EQ is entirely optional.

Trend EQ Basics

The Trend EQ Screen

When the Trend EQ screen opens, four data pills are displayed at the top providing context for the trend calculation:

• Effective Date — the effective date of the requested bid.
• Historical Midpoint — the midpoint of the historical claims data used in the analysis.
• Future Midpoint — the midpoint of the future contract period.
• Trend Period — the total trend period in months, calculated from the historical midpoint to the future midpoint.

Trend is applied using a midpoint-to-midpoint methodology. All trend figures are entered as annual rates and are compounded across the trend period.

Standard Drug Categories

By default, Trend EQ opens to the Global Assumptions view, where trend rates can be applied to four standard drug categories:

• Specialty Brand
• Specialty Generic
• Non-Specialty Brand
• Non-Specialty Generic

Within each category, two trend inputs are available:

• Cost — adjusts the unit price of claims in that category.
• Utilization — adjusts the claim count for that category.

Global assumptions apply to all bidders by default unless a PBM has been given its own custom assumptions. See the Custom PBM Trend section below for details.

Custom PBM Trend

While global assumptions apply across all bidders by default, Trend EQ also allows you to define trend assumptions specific to an individual PBM when your analysis calls for it.

Switching between PBMs

Use the PBM dropdown at the top of the screen to switch between the Global Assumptions view and the individual view for any bidding PBM.

Untethering a PBM from global assumptions

By default each PBM is tethered to the global assumptions, meaning any changes made to the global view automatically flow through to that PBM. To apply PBM-specific assumptions:

• Select the PBM from the dropdown.
• Uncheck the Use global assumptions checkbox.
• Enter the trend assumptions specific to that PBM.

Once a PBM is untethered, changes to the global assumptions will no longer flow through to it. That PBM will retain its own custom assumptions independently of global.

Note: PBMs that have been untethered from global assumptions are indicated in the PBM dropdown with a broken chain icon.

Custom Categories

Beyond the four standard drug categories, Trend EQ allows you to build custom categories that target specific segments of your claim population with their own trend assumptions.

Adding a custom category

Click the + Add Custom Category button to add a new rule. Each custom category rule is defined using three fields:

• Field — the claim attribute to match against. Options are Guarantee Channel, GPI, or NDC.
• Operator — how the field is evaluated. Options include Is, Is not, Starts with, Does not start with, Contains, and others depending on the field selected.
• Value — the specific parameter to match against. For Guarantee Channel, values are selected from a list. For GPI and NDC, values are entered as text.

Once the rule criteria are defined, enter the applicable Cost and Utilization trend rates for that category.

Rule priority and overlap

Multiple custom category rules can be created and reordered by dragging them into the preferred order. If a claim matches more than one custom category, the highest-ranked rule in the list takes precedence.

Note: All custom categories are evaluated before the four standard drug categories. A claim that matches a custom category will not also be evaluated against the standard categories.

Importing Trend EQ Profiles

Stored Trend EQ profiles can be imported directly into the Trend EQ screen, making it easy to apply a consistent set of assumptions across multiple RFPs without re-entering them manually.

How to import a profile

Click the Import Trend EQ Profile dropdown in the upper right corner of the Trend EQ screen. Select the profile you would like to apply. The imported profile will overwrite the current assumptions for whichever context you are viewing — whether that is Global Assumptions or a specific PBM.

Profile association

Each stored profile displays an associated PBM name, which is provided for organizational reference only. Any stored profile can be applied to any bidder or to the global assumptions regardless of its listed association.

Note: Importing a profile for a specific PBM will automatically untether that PBM from global assumptions.

Storing Trend EQ Profiles

Trend EQ profiles are created and managed from within the Administration section of the platform. Stored profiles are available for import across all RFPs in your organization.

Creating a profile

Navigate to Administration and open Org Details. Select the Trend EQ tab. Click Create Trend EQ Profile to open the profile creation screen.

The profile creation screen works the same way as the Trend EQ screen within the financial summary workflow, with three additional fields:

• Name — a required label used to identify the profile in the import dropdown.
• Associated PBM — an optional organizational reference indicating which PBM the profile was built for. This does not restrict which bidder the profile can be applied to. A Global option is available for profiles not specific to any one PBM.
• Active / Inactive — controls whether the profile appears in the import dropdown within the financial summary workflow. Inactive profiles remain stored but are hidden from the import list.

Note: Custom categories can be added to stored profiles the same way they are added within the financial summary workflow.