With two Harry Potter fans still living at home, our family couldn't wait to visit The Wizarding World of Harry Potter last week while on vacation in Orlando, Fla. Our family of four "muggles" whizzed around on broomsticks, played Quidditch and drank delicious butter beers in this land of magic and illusion at Universal Studios.

We waited for over an hour to get into Ollivanders Wand Shop and exited with two wands, one made of aspen with a phoenix tail feather and another made of birch with a unicorn hair. Total fantasy, but my children enjoyed swishing and flicking their wands for the rest of the trip.

Wouldn't it be wonderful if you could wave a magic wand and cure cancer or other debilitating diseases? While there is no magic potion that can save the world, we are provided with a wide range of prescription medications which, even a few years ago, would have been considered a magic elixir.

The cost of prescription drugs, especially in the emerging biomedical field often known as "designer drugs," is escalating at a rapid pace. It is more important than ever that employers engage a strong pharmacy benefits manager partner to manage prescription drug costs. See below for 10 ways to evaluate your PBM. -L.S.M.

Contributing Editor Laurie S. Miller is president of Miller, Buettner & Parrot, Inc., an employee benefits consulting firm in Rockford, Ill. She can be reached at lmiller@mbbenefits.net.

 


 

Top 10 Ways to Evaluate a PBM

1. Competitive pricing

The PBM should have the purchasing power to leverage the best pricing by driving volume to cost-effective providers. This includes a strong formulary and competitive specialty-drug pricing.

2. Exceptional service

Confirm the PBM has a strong network of pharmacies, including mail order.

3. Transparency

Ensure the PBM is willing to share the details of its contracts with the vendors, including rebates.

4. Auditing and measurement

Review the performance of the PBM to confirm it is delivering what it promised.

5. Member education

You want a PBM that will educate the members on the $4 generic programs and other low-cost programs. Also seek a PBM that provides an annual report to members, showing drug spend.

6. Provider education

Partner with a PBM that provides education to promote generics and the most cost-effective drug therapies, and other education opportunities on a regular basis.

7. Drug adherence programs

The PBM should provide member outreach programs to encourage the correct utilization of medication.

8. Clinical programs

Support for clinical programs - including avoiding drug interactions and targeting potential abuse, and managing chronic health conditions - is a key attribute. Also important is offering step therapy and prior authorization.

9. Flexibility and creativity in plan design

10. On-staff experts, including clinical pharmacists for consultation and evaluation.

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