MKC Strategic Solutions
MKC Strategic Solutions

Specialty Therapeutics Access, Benefit Verification & Reimbursement Consulting

Specialty drugs· PBM reform· GLP-1s & peptides· Benefit verification

Independent consulting from a practicing clinical pharmacist working the access and reimbursement problem from the inside: prior authorization, payer policy, PBM structure, and the emerging GLP-1/peptide landscape. Advisory work, expert network consultations, and published policy analysis.

MKC ACCESS VERIFICATION REIMBURSEMENT POLICY
How an access problem moves through this practice Benefit verification lifecycle
Under review
Policy, formulary, and PBM structure analyzed against current payer rules.
Resolved
Clear path to access, reimbursement strategy, or a documented policy position.
Applied
Delivered as advisory guidance, expert network insight, or published analysis.
Focus Areas

Four connected problems, one practice

Each area feeds the others — benefit verification work surfaces the PBM and policy patterns that show up in the writing and advisory calls.

01

Specialty Therapeutics Access

Prior authorization strategy and payer policy navigation for specialty and biologic drugs, built from direct clinical coverage-determination experience.

Prior AuthBiologicsPayer Policy
02

Benefit Verification Systems

Evaluating and designing benefit verification workflows and technology, drawn from hands-on work building a multi-phase verification playbook and tooling.

BV WorkflowPA ReadinessTech Evaluation
03

PBM Reform & Policy

DIR fees, white and brown bagging, preferred network exclusions, and the independent pharmacy pressure points these create.

DIR FeesNetwork DesignPolicy Analysis
04

GLP-1 & Peptide Strategy

Medicare bridge program mechanics, peptide reclassification policy, and counseling and access pathways as this category moves fast.

Medicare BridgePeptidesGLP-1 Access