TransparentRx Newsletter - September 2022 👀
Pass-through pricing means that the PBM passes the discounts, rebates, other revenues, and actual costs charged by the pharmacy or paid by a pharmaceutical company (in the form of refunds) directly onto the plan sponsor. In actual use, it can have various definitions according to the understanding of the parties.
PBM selection decisions often boil down to price. It’s a common mistake as the actual cost of PBM services encompasses more than just price. There are four primary drivers of pharmacy cost price being the most obvious. Equally important drivers of pharmacy cost include product mix, utilization, and cost share. Let’s take an in-depth look at 5 things to do immediately about drivers of pharmacy costs.
Fake medications cause in excess of 1,000,000 passings every year, as per the World Health Organization (WHO)[i]. It's a sufficient scourge that a large gathering of specialists grouped together in 2019 to pronounce the ascent in "misrepresented and unsatisfactory meds" nothing short of a "public health crisis," one that kills 250,000 youngsters every year. Is drug importation a valid prescription?
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Whenever you are ready, here are a couple of ways we can work together: Education. The Certified Pharmacy Benefits Specialist (CPBS™) credential offers continuing education through forty-five state departments of insurance, ACPE, SHRM, and HRCI. The University of Kentucky HealthCare CECentral is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Register today and get an early bird discount worth up to $500 off. It is the most important credential to hit the employee benefits industry in the last 40 years.
PBM Services: Some of the advantages of working with a Fiduciary PBM include having no direct pharmacy ownership (mail, specialty, or otherwise) since that introduces a conflict of interest. With specialty prescriptions accounting for upwards of 50% of total pharmacy benefit spending for many employers, there is comfort in knowing that the PBM is not incentivized to dispense high-cost medications to drive the PBM bottom line. A fiduciary is required to pass through all manufacturer rebates to the client and retains no funds received from drug manufacturers because that would also introduce a conflict of interest. The sole source of compensation for a Fiduciary PBM is administrative fees billed with full transparency, free of hidden revenue or margins. TransparentRx is America's first fiduciary-model PBM.
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