PBIRx's Proprietary Specialty Drug Tool Box

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

 

As experts in the pharmaceutical field, PBIRx thrives on providing the best pharmacy benefit solutions to any entity that offers benefits to its employees or members.The demand for high cost oral and injectable specialty drugs continues to rise with existing drugs getting FDA approval for new indications, which dramatically increases utilization. Between increased utilization, new specialty drugs launched and manufacturers increasing prices several times a year, specialty drugs are now representing up to 40% or more of the total pharmacy benefit spend.

Management of not only the cost of the specialty drug, but also effecting a positive and lowest cost healthcare outcome requires many components beyond just the actual specialty drug discount provided by the PBM. That is why at PBIRx, we have developed a proprietary Specialty Drug Tool Box that is used with every client to manage the growing segment of the pharmacy benefit.

The following provides some insight on our Specialty Drug Tool Box with various components to consider in optimizing management of rising specialty drug costs:

1. Price: First and foremost, it is important to know and understand about specific discounts and rebates that are available for various specialty drugs including generics, biosimilars and limited distribution drugs.

2. Channel Management: Drug discounts, member management services and rebates vary based on the specific dispensing facility i.e retail pharmacy, PBM owned specialty pharmacy, doctor's office, in house hospital pharmacy, infusion center and approved limited distribution specialty pharmacy.

3. Clinical Review and Management: Significant savings can be achieved beyond the drug discount by using various clinical algorithms to identify and implement programs resulting in overall low cost positive healthcare outcomes.

4. Clinical and Pharmacoeconomic Outcomes: Lastly, once a plan is in place it's time to make sure you are managing the patient's disease state to include coordination of care, medication adherence and disease management.

For more information on our Specialty Drug Tool Box or how PBIRx can help you manage your pharmacy benefits, visit us at www.pbirx.com or contact us at (888) 797-2479 today!