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3 ways to reform the pharmacy benefits industry

1 month ago 28


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Pharmacy benefit managers have been in the news a lot lately as they are an important component of the ongoing drug price debate in this country. Consolidation, legislation and litigation pepper the sector.

At the upcoming INVEST Digital Health conference in Dallas set for September 28, in collaboration with Health Wildcatters, a panel discussion on the future of pharmacy benefit managers will be part of the larger conversation on employee benefits. One of the panelists for that discussion is AJ Loiacono, CapitalRx CEO. In response to emailed questions, he shared three things he’d do to reform pharmacy benefit management:

Create a public register of “net” drug prices, so consumers and employers are never taken advantage of the block box of drug pricing again.

Eliminate spread pricing on drugs

No one should make money by marking up the price of a drug, especially in a system where price is already an illusion (see Point #1)

Remove the ability for brokers and consultants to be paid by carriers, PBMs, and other point-solutions

No one should be paid for recommending a healthcare product, it creates a horrible conflict of interest.  Any fee for advice or placing PBM business, should be a reasonable, fully-disclosed, and paid for by the payer in a separate bill (employer group)

Register now for INVEST Digital Health and be part of the conversation on drug price reform and topics spanning investment trends between the coasts to tech tools helping employers reduce healthcare costs. There will also be our startup pitch contest, Pitch Perfect, which will focus on startups developing tech geared to employee benefits. To view the full agenda, click here.

Among the speakers scheduled to take part in the conference are:

  • Dr. Mona Flores, global head of medical AI, NVIDIA
  • Hubert Zajicek, co-founder and partner, Health Wildcatters
  • Jason Considine, chief commercial officer, Experian Health
  • Adrian Rodriguez, vice president of quality and safety, Mark Cuban Cost Plus Drug Company, PBC
  • Joshua Fredell, head of PBM and specialty product innovation, CVS Caremark
  • Adam Dakin, partner, HealthTech, Dreamit HealthTech

Photo: Devrimb, Getty Images

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