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Your PBM says they met their guarantees, but did they save you money?
We have previously discussed the standard methods used to evaluate PBMs and how contract definitions can impact PBM accountability in complex ways. In addition to contract definitions, another critical aspect to driving PBM accountability is understanding drug utilization mix. If you evaluate PBM performance using aggregate pharmacy network discounts and rebate payments (which is the… Continue reading Your PBM says they met their guarantees, but did they save you money?
Why are drug prices so high? The answer in two charts
It’s clear to most Americans that our medical costs are higher than they should be, and that drug prices in particular are growing out of control. These rising costs place a massive burden on America’s businesses, particularly small- and medium-sized businesses, as well as American families directly.
Independent pharmacies vs. big chains: who has better prices?
The economics of the U.S. healthcare system can be confusing, especially when it comes to pharmacy benefits. Under “normal” retail conditions concepts like “economies of scale”, “supply and demand”, “consumer choice” drive business decisions. It is not that these concepts do not exist in healthcare (they do), it is just that they don’t always lead to intuitive outcomes.
PBM contract guarantees 101: network discounts and manufacturer rebates
We are approaching the last quarter of the year which means renewal season for many self-funded employers. It is a great time to take a step back and think about your pharmacy benefits contract. The standard pharmacy benefits contract utilizes two main components to hold PBMs accountable to their performance