PBMs are the Gatekeepers to Managing Employees’ Drug Abuse

In 2018, the opioid epidemic cost the country $179 billion in mortality related expenses, health care expenses, lost productivity, criminal justice expenses, and assistance. The opioid epidemic is a preventable and complex public issue that arises from a myriad of causative factors. Because of this, the solutions needed to effectively end the opioid epidemic require multiple stakeholders, including healthcare providers, pharmacies, drug manufacturers and employers. Highlighted among the participants in ending this crisis is the pharmacy benefit manager (PBM).  PBMs...

PBMs Lower Health Costs, Improve Outcomes for Patients

266 million consumers are fighting to keep prescription drugs accessible and affordable. PBMs are advocating for them. By using advanced tools to manage pharmacy benefits, negotiating price concessions from drug manufacturers, improving patient adherence to prescriptions, encouraging generic drug use, managing high-cost specialty medications, and offering more affordable pharmacy channels, PBMs are vying to achieve overall stability for the cost of prescription drugs.  It is estimated that in the next decade, PBMs efforts will save plan sponsors and consumers over...

Assessing the Clinical Utility of Patient Requested Lab Tests

Due to skilled and sometimes aggressive marketing that enthusiastically directs patients and labs towards new, proprietary tests, laboratorians must be diligent about assessing the evidence-based clinical utility of the tests.  A large part of the difficulty in this task lies in the fact that often patient requested testing is a response to clinical conditions that involve profound patient suffering. Naturally, the patient wanting to understand more about their condition in the face of their own suffering is understandable. This increases...