Many Americans are surprised to learn that a minor medical issue resolved painlessly through an outpatient procedure – or the prescription of a simple medication – could have been life threatening mere decades ago. We take for granted the miracle of modern medicine, and that these miracles are often very expensive.
That is why Pharmacy Benefit Managers or PBMs are so proud of their record of saving hundreds of millions of patients hundreds of billions of dollars a year on their prescription drugs. The work PBMs do has led to an approximately 30 percent discount for consumers on their prescriptions.
Their success as patient advocates is the result of creative approaches to health care:
Drug Price Negotiation and Rebates
PBMs can lower drug costs by negotiating discounts and rebates from pharmacies and manufacturers.
The more sellers you encounter in any marketplace, the more they’re forced to compete to earn your business. The network of pharmacies PBMs have built competes by offering better service, more convenience, higher quality, or a lower price — or a combination of them.
Generic Drug Utilization
Generic drugs, which are essentially copies of brand-name drugs, allow greater access to health care. They perform like the brand-name original but at a lower cost. Increasing their utilization saves money and expands access.
Specialty pharmacies provide patient education and clinical support beyond the capabilities of a traditional retail pharmacy. They better respond to the evolving needs of patients, providers, payers, and drug manufacturers, offering a full range of clinical and operational services to enhance the safety, quality, and affordability of care for patients.
Health plans and employers offer their members the option of lower copayments on 90-day supplies of medications if they choose home delivery. In addition to providing significant cost savings, mail-service pharmacies are more accurate dispensing medications than brick-and-mortar pharmacies.