Pharmacy benefit managers are under scrutiny for their business practices that are often blamed for contributing to the rising costs of prescription drugs in America. But one PBM is paving another way that alters the traditional operating model.
Losing these retail medication outlets creates more than just pharmacy deserts. In many low-income and underserved areas, drugstores also serve as grocery stores and hubs for essential services, and hence their closures mean communities lose crucial access points for a variety of goods and services.
Alan Murray on improving access for medical transportation.
Season 2 of the MedCity Pivot Podcast has launched with a special focus on the evolution of pharmacy and pharmacy benefit management. The first guest this season is A.J. Loiacono, who leads Capital Rx.
The largest six pharmacy benefit managers are being scrutinized by the Federal Trade Commission, while Congress is debating the Pharmacy Benefit Transparency Act. Meanwhile, states have their own ideas for reining in what they see as excesses of the industry. With all this heat, what is the message from the head of the Pharmaceutical Care Management Association?
Large employers, particularly self-insured companies, can demand a better and fairer system. They can use their contracting power to insist that their plans cover all FDA approved drugs.
The PBM industry—a transaction-driven industry that highlights economic distribution, resting squarely on price, rebates, and discounts—has consistently let down employers and patients with models that behave like retail.
How can AI benefit and improve patient outcome in the emergency department? Watch the latest episode to find out.
PBMs today have a tremendous opportunity to help address health disparities by shifting current drug pricing and “cost vs. access” conversations to value-based discussions.