Holding PBMs Accountable for Clinical Management
by Kenneth B. Berry and Kristin Begley, Pharm.D.
Drug plan sponsors can lower drug spending and improve member outcomes by working with pharmacy benefit managers (PBMs) that use strong, high-touch clinical management programs.
Amid rising drug plan costs, the employee benefits industry continues to push increased transparency in pricing from pharmacy benefit managers (PBMs) in hopes of removing misaligned rebate-driven behavior. However, by focusing only on the difference between a traditional pricing model and a transparent pricing model, the industry is missing something.
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