Don’t Use the High Priced Spread

The right Pharmacy Benefit Manager (PBM) can make a huge difference. If you follow my column, you have heard this before. For years, we have advised our clients of the three essential components of smart PBM selection:

• Transparency;

• Value Added Services;

• Competitive Pricing.

Jayne O’Donnell, writing in USA Today, reports how states from Florida to Washington are considering legislation to mandate additional PBM disclosure/transparency.

Unfortunately, many carriers, TPAs and self-funded employers believe once a PBM is selected, they have done all they can. They ignore the secret, but highly profitable, machination called “spread pricing.” Here’s what you need to know:

Some PBMs…

…have “special” deals with drug makers.

…are ineffective at questions of appropriateness, extent and duration.

…give rebates to favored middlemen/brokers/TPAs.

…are bigger and more profitable than many drug manufacturers.

 

Sometimes you need a partner to dig a little deeper.

Call us. We can help you pick the right PBM.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

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