Pharmaceutical Benefit Managers

1326 Words6 Pages
Suppose that you are a pharmaceutical benefit manager. First, briefly assess various pricing strategies that could be used to charge employers for prescription drugs. Pharmaceutical benefit managers process prescriptions for the groups that pay for drugs, usually insurance companies or corporations, and use their size to negotiate with drug makers and pharmacies. This latest deal continues the consolidation trend but also highlights how the industry is becoming more than just an administrator and negotiator. Pharmacy benefit managers (PBMs), act as an intermediary between the payor and everyone else in the health-care system. They generally make money through service fees from large customer contracts for processing prescriptions, operating mail-order pharmacies, and negotiating with pharmacies and drug makers. Their contracts can include incentives for cutting costs (Gryta, T., 2011). The use of a comprehensive generics program can significantly lower prescription drug costs, control utilization and play a major role in helping to improve overall patient outcomes. An estimated $35-$40 billion worth of branded drugs will lose their patent protection within the next five years, allowing them to be processed and marketed in generic form. Prescription drugs losing their patents are represented in some of the highest cost, highest utilization therapeutic categories, including depression, hypertension, gastrointestinal, pain management and antihistamines. The various pricing strategies that could be used to charge employers for prescription drugs used as drug pricing by PBMs utilizes the following tools are: Wholesale Acquisition Cost (WAC) - the cost-basis PBMs utilize to establish the price of generic drugs. It is calcula... ... middle of paper ... ...January 2014 at http://www.nursingcenter.com/Blog/post/2011/05/27/8-rights-of-medication-administration.aspx Jones, John D. (2003). Developing an effective generic prescription drug program. Benefits Quarterly, 19(1): 14-18. Retrieved on January 2014 from Proquest at http://search.proquest.com.ezproxy.trident.edu:2048/docview/194951070/1431E31606748D5718A/1?accountid=28844 Gryta, Thomas. (2011, July 21). What is a 'Pharmacy Benefit Manager?' Retrieved from the worldwide web on January 2014 at http://online.wsj.com/news/articles/SB10001424053111903554904576460322664055328 McKeon, Leslie. (2011, January/February). Preventing never events: What frontline nurses need to know. Retrieved from the worldwide web on January 2014 at http://mobile.journals.lww.com/nursingmadeincrediblyeasy/_layouts/oaks.journals.mobile/articleviewer.aspx?year=2011&issue=01000&article=00010

More about Pharmaceutical Benefit Managers

Open Document