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Managing prescription drug costs for businesses is a complex challenge. While solutions from famous names capture attention, the most effective strategy lies in consulting experienced Benefit Advisors and Consultants. These experts thoroughly evaluate pharmacy benefit options to provide cost-efficient solutions. Discover how their guidance can optimize your pharmacy benefits. Read the full article from Aaron Bren to gain valuable insights and take proactive steps towards cost-saving strategies. https://lnkd.in/gCQqUDPx

CVS Pharmacy is introducing changes to how its prescription drug pricing model works. Here's what you need to know. 💊CVS said it will role out a new reimbursement model designed to make costs more predictable at the drugstore counter. 💊This new model involves a formula based on the cost of the drug, a set markup and then a fee for filling the prescription. 💊CVS drugstores will start using this model next year but it will be more broadly available in 2025. #cvshealth #cvspharmacy #healthcare

Finding solutions for managing prescription drug costs for businesses can feel like finding a needle in a haystack. This article highlights the crucial role that experienced Benefit Advisors and Consultants play in analyzing pharmacy benefit options. While flashy solutions from celebrities and big brands grab headlines, the best strategy is still seeking innovative advice from a trusted partner to find clear, cost-effective solutions. Read more: https://lnkd.in/gmAS4gM8

This article does a good job highlighting the opportunity plan sponsors have to manage their prescription drug spend. It explains that plan sponsors that self-insure have more options at their disposal than those who are fully insured. These are all good recommendations: 1️⃣ Leverage Technology 2️⃣ Manage Plans Carefully 3️⃣ Find the Right Partners 4️⃣ Take Advantage of Disruptions to the Status Quo I'd like to elaborate on the fact that the largest national insurance providers and their embedded PBM partners have the ability to do this better than anyone else. However, the misaligned incentives and commitment to maximize profits over people prevent them from doing so. Plan sponsors must be conscience of the part their trusted partners play in the perpetual price increases and lack of assistance insurers provide in helping their clients and their members manage the Rx spend. And let's not forget that some of the costliest medications are not pharmacy claims, but rather medical claims because of the way they are sourced or administered.

The traditional relationship between pharmacy benefit managers (PBMs) and payers has long been the model for prescription drug cost management. However, this model may need to change. Blue Shield of California has decided to move away from PBM relationships. They instead are taking full control of engagement with pharmaceutical stakeholders in an attempt to cut down rising drug costs. This is a move to streamline the entire process of prescription drug cost management with greater transparency in order to overall enhance the patient experience. This is a big change that upsets the status quo. It will be very interesting to see how this plays out through the industry. #Healthcare #Relationships #Access #Accessibility

"This bill, the Delinking Revenue from Unfair Gouging (DRUG) Act, would do is demolish a system in which PBMs are pushing drug manufacturers to set higher list prices for pharmaceuticals. Linking PBM revenues to the manufacturers’ original “list” price is one of the most egregiously anti-consumer practices in healthcare. By holding formulary placement over their heads, the PBMs can successfully demand large rebates and other fees from manufacturers. Adding insult to injury for consumers, out-of-pocket cost-sharing requirements are usually based on the original list price rather than the discounted price that the PBMs pay." https://lnkd.in/dDj2fBvG

Drug Channels News Roundup, September 2023: PBM Profits, Specialty Rx Markups, CVS Spending Trends, Pharmacy Pricing Secrets, and Deductibles 101: Autumn is here! Curl up with your favorite pumpkin-spiced blog and savor these stories harvested from the great Drug Channels patch: * A must-read report on hidden sources of PBMs’ profits * How generic drugs drive specialty pharmacy profits * CVS Health’s unadvertised 2022 drug trend report * A shocking look at how PBMs set prescription prices Plus, Dr. Glaucomflecken teaches us about our insurance benefits. P.S. Join my more than 45,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter/X, where I have more than 16,900 followers. (I recommend that you follow me on LinkedIn, because the quality of comments and engagement is much higher than they are on Twitter. I’m not posting to Threads yet.) Read more » Copyright © 2006-2023 Pembroke Consulting, Inc. d/b/a Drug Channels Institute. Drug Channels® is a registered trademark of Pembroke Consulting, Inc. This Feed is for personal non-commercial use only. #pbm #drugpricing #pharmaceutical

We've put together a free training video to help refresh you on Pharmacy Benefit Management and how PBMs function in the healthcare industry. Stay brushed up and learn how to evaluate your relationship by watching the video here. #Pharmaceuticals #PharmacyBenefits #SpecialtyDrugs #PBM #Truveris

Brush up on Pharmacy Benefit Management and the role of PBMs in the healthcare industry with this refresher video and learn what you should be looking for in your PBM relationships. #Pharmaceuticals #PharmacyBenefits #SpecialtyDrugs #PBM #Truveris

Arizona governor Katie Hobbs recently unveiled a supportive plan to help our neighbors in facing skyrocketing prescription drugs costs. This initiative promises a new Prescription Drug Affordability Division to help them save on medications. The division would help ensure pharmacies are being clear about prices and protect consumers from price-gouging practices. In recent years, the impact of past high prescription costs cannot be overstated as it has cast a long shadow over the lives of countless Arizonans, forcing many to navigate a harrowing maze of financial and health-related dilemmas. Many families have been torn between the imperative to manage chronic conditions and the necessity to maintain financial stability, often leading to heart-wrenching compromises and adverse health outcomes. The proposed plan to cap medication costs and enhance transparency within the pharmaceutical industry represents a critical step forward. It would mark a significant shift towards a future where no Arizonan is left to choose between their health and their financial security. This visionary approach aims to ensure that essential medications are within reach for everyone, heralding a new era of health equity and dignity. A New Leaf has witnessed firsthand the heartbreaking impact that high prescription drug costs have had on the individuals and families we serve. The prospect of a future free from these burdens aligns with our deepest values and aspirations for our community. We believe that this plan creates the potential for a healthcare system that serves the needs of the many, not just the few. We can turn the tide against high prescription drug costs and move towards a future where healthcare is accessible, affordable, and equitable for all. Let's embrace this opportunity to make a lasting difference in the lives of our fellow Arizonans! https://lnkd.in/gMv2KFia