Recently, 60 Minutes hosted an expose’ about healthcare cost increases which are driven by waste/price manipulation in the pharmaceutical industry. Please click on the below link to view a brief/informative documentary on the subject,.
You may want to know what strategies can be deployed to address this issue. First, every employer’s situation is unique; however, the following general guidelines apply:
If you are fully insured, there is very little you can do to address these issues. Management, or lack thereof, will be up to the insurance carriers, which can have misaligned financial incentives tied to the structure of the formulary.
If you are large enough to be self-funded, applying scrutiny to the PBM contract is the clear recommendation. That scrutiny, which can take on many forms, is best performed by a stakeholder aligned with the best interest of employers and their employees and not the insurance carriers and/or the PBM’s.
Here is a recent blog post we published on “The Top Five Responses to Ward Off Rising Pharmacy Cost“. It presents some insightful strategies to consider.
Please contact us with questions at www.benefitcompany.com or 678-904-9333.