The PBM Model of the Future: Why Payers Are Unbundling PBM Services
Javier Gonzalez, Chief Growth and Commercial Officer at Abarca, about why payers are increasingly looking for alternatives to the traditional PBM model.
Blue Shield of California is cutting many of its ties with CVS Caremark (though not all) and adding four additional partners for its prescription drug benefits. These partners include Mark Cuban Cost Plus Drug Company and Amazon Pharmacy. The changes are needed to disrupt the current broken system, said Salina Wong, senior director of clinical pharmacy programs at Blue Shield of California.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Panelists at a recent pharmacy conference were optimistic about the future of value-based drug contracting. For example, one said that healthcare will be close to establishing a value-based formulary by 2030, and another said that longitudinal patient tracking will become a more important part the drug pricing process.
Panelists at a recent healthcare conference expressed optimism about the automation technology that health plans, pharmacy benefit managers and providers can adopt to facilitate real-time data sharing. They said that such technology has potential to improve medication adherence, reduce costs and save time for both providers and payers.
The contracts are complicated and full of risks for drug companies. But there's also a risk to steering clear of the arrangements -- reduced or restricted access to a company's medication.