Even if you haven’t noticed dips in PBM reimbursements, you’ll probably feel the effects on your bottom line. Lower margins on PBM-negotiated products are another obstacle to a pharmacy’s financial stability, and financial instability can impact the quality of patient care.
In this article, we’ll discuss the strain of lower PBM reimbursement and why smarter purchasing is essential to counteracting it.
How PBMs Affect Your Pharmacy
There’s a lot of debate around PBMs, their impact on pricing, their level of transparency and other issues. This article will focus on how they affect pharmacies and what you can do to stay competitive amidst those challenges. First, here’s a brief refresher about PBMs.
Think of a PBM (pharmacy benefit manager) as a representative for health insurers and other larger payers. PBMs are a third party managing prescription benefits. Their role is to negotiate with drug manufacturers and pharmacies. PBM negotiations include the medications covered by payers (i.e., formularies), rebates offered by drug manufacturers and reimbursements available to pharmacies. Along with drug prices and patient access, these negotiations affect payment to pharmacies for the products dispensed. Read more >
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