Host Mike Koelzer speaks with Joey Dizenhouse, an actuary and PBM expert at HealthTrust, about the intricate relationships between PBMs, pharmacies, and plan sponsors
Negotiation requires leverage, subject matter expertise, and tenacity Joey explains his role in negotiating master agreements between PBMs and the entity with their insurance plan, ensuring the incentives of the PBM align with the best interests of the plan and its members
Negative impact of choosing brand name drugs over cheaper generics on pharmacies Importance of preserving competition in the industry to ensure consumers receive the best value
Delays in launching generics and biosimilars can impact plan sponsors
Rising cost of pharmacy expenses and the need to stay ahead of the curve to protect against future increases
Factors that contribute to the rising cost trend in pharmacy, and how good contracts with PBMs can provide flexibility while educating prescribers and patients about the cheapest available drugs Importance of a medical exception process to ensure access to expensive medications
Communication between PBMs, patients, and healthcare providers is crucial
Role of pharmacists, brokers, and consultants in navigating the complex world of PBMs.
https://healthtrustpg.com/
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