When reviewing a PBM contract and benefits plan, there are a few areas I always analyze to ensure maximum savings are being achieved for my clients. Areas of concern are formularies, benefits design and specialty/mail pharmacy.
If you’re reading this blog, you’re most likely aware how cumbersome and intricate pharmacy benefit management (PBM) contracts can be. Negotiating these contracts properly takes a deep understanding of PBM business practices and definitions, industry-specific language, and pricing structures.
The recent article “Pharmacy-Benefit Managers Under Pressure” published by Barron’s discusses how prescription drug prices are rapidly rising, how this affects employers and the reason behind the rising costs. At Crystal Clear Rx, we work closely with PBMs on a daily basis, and I can certainly attest to many of the points made within the article.
Times they are a changin’ AGAIN With the Walgreens announcement last week of the acquisition of Rite Aid, things just got even more interesting in the Pharmacy Benefits arena. It now appears we will have two Retail ownership based PBMs in the marketplace. Here is what we know: Rite Aid is to become a wholly owned subsidiary of Walgreens Boots Alliance The Rite Aid stores will operate as Rite Aid for an undefined period.