What Pharmacy Benefit Management Can Offer
Posted on Monday, May 27, 2019
SharePharmaceuticals remain the most expensive component of health care for many Americans. This helps explain why pharmacy benefit managers (PBMs), which serve to ease the financial burden, are continuing to grow in popularity.
PBMs can be affordable for employers, easy to use, and they promote prescription drug education and safety. These managers fill a void by containing prescription drug costs and providing patients with valuable services that significantly improve their overall pharmacy experience.
One function of PBMs is to secure discounts from drug manufacturers and pharmacy retailers on behalf of health plans and
In the Year of the Study
An industry study estimates that in one year, PBMs reduced prescription drug costs by 29 percent.
That same year, for individuals in private health care plans, the expected annual reduction in prescription drug costs was $397.
Total estimated savings that year was $85 billion from the use of PBMs, and over the decade that follows, $1.3 trillion.
In the study which spanned nine years, PBMs drove down prescription drug costs by 73 percent.
- Source: The Pharmaceutical Care Management Association
members. They also encourage the use of more economical generic drugs and mail service pharmacies. But just as important, they work to enhance the safety of prescription drug use. By providing physicians, patients, pharmacists and plan sponsors with timely warnings and valuable information about the potential harm of taking inappropriate medications, PBMs offer prescription medicine plans a level of safety.
Pharmacy benefit managers successfully maintain extensive databases of important patient information, complete with each individual's prescription drug history. PBMs also offer mail service pharmacy controls by upholding high rates of dispensing accuracy for the growing volumes of mail order prescriptions.
Most recently, pharmacy benefit managers have worked to increase patients' access to the drugs they need, and have done so with great efficiency. This is reflected in the home delivery sales growth rate that has jumped 22.4 percent, and now represents 17 percent of all prescription drug sales.
As a result of their success, PBMs are enjoying enormous popularity. These prescription drug plans now offer financial relief and safety to more than 213 million Americans. And waiting in the wings are Medicare beneficiaries who might benefit from PBMs, as Congress considers adding this cost-effective option to existing Medicare coverage.
Nevertheless, industry experts agree that PBMs must do a better job of educating policymakers and others about the benefits of their services, and at answering charges levied by interests that are threatened by the success of the industry.
A recent study shows that, in the case of three of the largest health plans offered to federal employees and retirees, PBM member companies have saved them more than 50 percent on the full retail cost of prescription drugs charged by pharmacies. With that kind of success, pharmacy benefit managers are something businesses should consider.
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