Search Results for: PBM

Many practitioners, both prescribers and pharmacists, responded to Tuesday’s article The System is Broken. Most were in agreement with the frustrations described, and many had experienced similar issues with their own patients. Some pointed out that the immediate release guanfacine’s labeled indications only include hypertension while the extended-release guanfacine, a more expensive formulation, is indicated for ADHD. … Continue reading Follow-up: The System is Broken.

For the past month we have been working with one our psychiatrists who is treating a mutual patient of ours. This patient has an intellectual disability, lives in a group home, and has significant history of depression with anxiety and attention deficit hyperactivity disorder (ADHD). One of his mediations that he has been taking for … Continue reading The System is Broken

The other day, I received an email notice from a Medicare Part D PBM: [highlight style=”yellow,”]UPDATE: You have Cases[/highlight]. The message continued on to state: 30-90 Conversion with $50 Payment for Positive Outcome I will be the first to admit that when I read case, I immediately thought of a clinical opportunity. The conversion of a prescription … Continue reading Is There Anything Special About the 90 Day Supply?

Pharmacists have been attempting to educate other about pharmacy benefit manager (PBM) tactics,  but few outside the profession understand the complexity and implications. Recently, however, congress and other have started paying attention to the associated costs of the PBM middleman. Benefit Design Specialists recently wrote about the implications in their blog, and it is an excellent summary of … Continue reading Re-Blog: “Your Health Plan Has a Serious Drug Problem.”

Previously, we have written that access to lives is important to any pharmacy, and the narrow, preferred networks that have become vogue in Medicare Part D are an example of an outside influence that can impact this access. The theory, of course, is that being in a narrow network will drive patients to a participating pharmacy, thereby … Continue reading The Flip Side of Access to Lives

The other day I wrote about PBMs and their role as Middleman (See The King is Naked). But every story has two sides. Today’s installment is a little more depressing: it relates to the economics of the current health care system. From a Wall Street perspective, retail pharmacy is at the bottom of the pharmacy … Continue reading Economics vs. Care