TAKE FIVE – Facilitate: A Cliff Note Series on Pharmacy Benefit Management

Over the past few weeks we have discussed finding a trusted advisor to educate you on the current pharmacy benefit landscape, investigating your benefit plan designs and pulling your claims data for analysis, validating with claims data opportunities to improving and tightening up your contracts, its pricing and clinical programs to eliminate waste. Now it is time to DO SOMETHING WITH THE RESULTS!

WEEK 4 - TAKE FIVE to Facilitate

Facilitate Your Strategy
Now it is time to create the road map to better pharmacy benefit management. For the Human Resources and Benefits Departments, this will require engagement with your employees. Tweaking copays, implementing clinical programs to eliminate waste and improve adherence for chronic conditions require guidance based on data. Your Pharmacist and Account Manager should be making recommendations on which programs are available, and their possible savings. Helping your employee or their family member deal with a chronic condition cannot be successful without proactive clinical outreach. Implementing a program, and assuming everybody knows about it, and is taking advantage of it, is wishful thinking.

Communication Matters

Especially for chronic diseases like diabetes, rheumatoid arthritis, MS, cancer, and Hep C, it is imperative to facilitate copay assistance programs by modifying copays and utilizing pharmaceutical grants for the benefit of the patient AND the employer. As an employer, why pay more than necessary? For the patient, getting financial assistance for their share of the specialty medication is critical to be able to manage affordability and adherence. BUT, the buck doesn’t stop there!!! Ensure there is a pharmacist proactively making patient outreach to discuss adherence, side effects, and that the assistance programs are working as they should. Just because there is a copay assistance program in place with your members enrolled does not mean you and they are maximizing savings opportunities.

Employers deserve someone to facilitate the complex world of pharmacy and specialty medication benefit management. We know from past experience - as shared last week - that increasing medication adherence has a direct impact on lowering your medical costs. Facilitating the implementation, communication and ongoing outreach of proper Rx benefit programs is a people business. We KNOW - we have seen it all!


Let Synergy Help YOU With Your Pharmacy Benefit Plan!
Pharmacy benefits are complicated, but services are available to help employers understand the complex prescription drug ecosystem. These services give employers and brokers the confidence that they can secure competitively priced PBM contracts, and maintain affordable, high-quality prescription drug coverage for their employees. So, for employers with midyear medical and pharmacy contracts expiring who are troubled by benefit costs and increasing trends, why not schedule a 30 minute conversation with me to discuss your concerns and needs!

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Pharmacy Benefit Management Solutions

Synergy Pharmacy Benefit Consultants, LLC
2111 Bagnell Dam Blvd #37
Lake Ozark, MO 65049

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