As healthcare costs continue to rise, benefits advisors and plan sponsors are increasingly turning to Pharmacy Benefit Managers (PBMs) to help manage and contain drug spending. However, the business model of the largest PBMs is fundamentally misaligned with the interests and needs of the customers and patients they purport to serve.
As explained in a recent article from BenefitsPro, these PBMs often prioritize their own profits over the health and financial well-being of their clients. To determine if your PBM is focused on your best interests, a good first step is to examine their business incentives. Are those incentives truly aligned with your needs?
PBMs should be incentivized to ensure the health of patients while managing constantly rising drug costs to secure the long-term health and viability of pharmacy benefits plans. However, in a fundamentally misaligned relationship, PBMs prioritize volume-focused, rebate-driven benefits with a restrictive formulary and limited network because their revenue model depends on it. This leads to unnecessary spending and poorer health outcomes for patients.
Working with a self-serving PBM can have significant, negative financial and health-related consequences for your organization. Recognizing this key fact, you can make an informed decision and choose a PBM that truly aligns with your goals.
At EmpiRx Health, our clinically driven pharmacy care puts the pharmacist at the center of the PBM service model, delivering the right care, at the right time, at the right price. This unique approach significantly reduces unnecessary utilization, thus improving patient health outcomes and delivering guaranteed cost savings.
Ultimately, your PBM should prioritize helping you to effectively manage rising drug costs so you can focus on what really matters: keeping your members healthy, happy, and productive.
Interested in learning more about customer-first pharmacy care? Contact us.
