What does a PBM do? Use this handy guide to explain

What does a PBM do? Use this handy guide to explain

We recently saw a well-done explanation of how PBMs interact with the patient’s journey and wanted to share it with our readers.

The short article was created by Pharmaceutical Care Management Association (PCMA), the industry’s representative organization in Washington.

While most of us are deeply familiar with that journey, it’s easy to forget that, to healthcare consumers, that process may not be as clear as it could be.

In the article, the reader is walked through six discreet stages, from doctor’s visit through medicine dispensing and beyond. 

If you regularly come in contact with patients, some of whom may be struggling with who’s who in their healthcare process, you might want to bookmark this short article about what PBMs do for patients for sharing.

And for a deeper dive into how PBMs can do better, check out these articles from VativoRx:

Unveiling the Future: Navigating the Evolving Landscape of 340B Rebates.

The 340B Drug Pricing Program, established in 1992, has been a crucial component of the healthcare system, dedicated to assisting eligible healthcare organizations in serving vulnerable patient populations by granting them access to discounted drugs. At the heart of this program are the 340B rebates, which enable qualifying entities such as safety-net hospitals, community health centers, and other eligible providers to acquire medications at significantly reduced prices.

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Martin Shields / Alamy Stock Photo

Humira – The End of an Era

In January 2023, the first biosimilar version of Humira, which is a widely used injectable drug for inflammatory diseases, was approved, marking the end of AbbVie’s two-decade market exclusivity. Humira is used to treat conditions like rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis, and it works by targeting certain proteins in the immune system.

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Biosimilars — Similar But Not Identical

You may have never heard of biosimilar drugs and that’s probably because they are not commonly prescribed in the United States even though they have been around for over 20 years. So, what are biosimilar drugs? A biosimilar drug is no different in terms of safety and effectiveness than a biologic product, also known as a reference product, and while highly similar it is not identical.

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Lower Cost Prescription Drugs from Canada, Is It Legal?

In the early 2000s, the FDA set up guidelines in the Regulatory Procedures Manual (RPM) that permitted prescription drugs to be imported from other countries if the patient met very strict guidelines. Just stating that the patient needed the drug due to cost savings was not a justification to obtain the drug.

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