Start a PBM Audit and 340B Consulting Firm

1. 1

   Earn the expertise the market pays for

   This is a credibility business: PBM consultants usually come from pharmacy, benefits brokerage, or PBM operations themselves; 340B consultants from covered-entity pharmacy departments or program administration. If you are adjacent but not yet expert, a role inside the machine for a year or two is the honest apprenticeship, supplemented by the certification programs the 340B world offers.

2. 2

   Pick your lead lane

   PBM auditing sells to self-funded employers, unions, and municipalities whose drug spend hides contract games; 340B consulting sells to FQHCs, safety-net and rural hospitals, and their contract pharmacy networks. The skills overlap but the buyers differ completely; lead with one and add the other as the firm matures.

3. 3

   Productize the PBM audit

   A defined engagement: claims re-pricing analysis against contract terms, rebate pass-through verification, spread pricing detection, and a findings report the CFO can read, followed by contract renegotiation support or an RFP process run against transparent-PBM alternatives. Fees run as fixed engagement pricing or a share of documented savings; either way, tie the invoice to numbers you proved.

4. 4

   Productize the 340B engagement

   Eligibility and registration support, contract pharmacy arrangement optimization, split-billing software audits, savings capture analysis, and mock audits against federal program requirements. Compliance is the wedge (covered entities fear audit findings) and unclaimed savings is the upside; engagements naturally become ongoing program-management retainers.

5. 5

   Sell through the channels that already have trust

   Benefits brokers and attorneys who lack pharmacy depth will subcontract or refer PBM work; state primary care associations and hospital associations convene exactly the 340B audience. Speaking at their events and publishing plain-language explainers of genuinely confusing rules is the entire marketing plan for a firm like this.

6. 6

   Grow from findings to standing counsel

   Every audit ends with a monitoring opportunity: annual re-audits, quarterly rebate verification, program dashboards, and on-call guidance as rules shift (and in both PBM regulation and 340B policy, they shift constantly). Retainers on top of audit fees are what turn a consultancy into a firm with employees and a valuation.

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