Drug pricing is typically the main factor brokers and employer groups consider when evaluating pharmacy benefit managers (PBMs). It makes sense. In a highly complex marketplace, their primary focus is getting their members’ prescriptions filled for the lowest price.
But projecting — and ultimately lowering — total drug spend is about more than discounts, dispensing fees and rebates. The clinical value a PBM can provide also plays a critical role in identifying savings. This means that a PBM that is seemingly more expensive at the outset may reveal more significant savings due to the clinical benefits it delivers. Here are three major factors brokers and employer groups should consider beyond unit cost when choosing a PBM.
