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Why Choose PBM Plus
Who Is Really Benefiting From Your Pharmacy Benefit Management Package?
The rapidly rising cost of prescription drugs has affected anyone that provides pharmacy benefits. Pharmacy cost increases continue to outpace every other segment of
healthcare on an annual basis with no end in sight. While plan sponsors continue to struggle with these huge cost increases the largest PBMs continue to report record
earnings and some face legal challenges due to their business practices.
Most PBMs operate under a business model where they receive the majority of their revenue from a source other than their direct client. PBMs traditionally have relied
heavily on revenue from two sources:
- Differences between pharmacy provider contracts and plan sponsor contracts, referred to as "spread"
- Pharmaceutical manufacturer formulary rebates
These revenue streams are generally not disclosed to clients but have a direct and significant impact on plan sponsored pharmacy benefit costs.
A Better Way
Trust and complete voluntary disclosure of all practices, policies, and revenue streams provide the foundation on which PBM Plus develops long-term business relationships
with our clients. This approach is entirely different from other PBMs and has always been the philosophy of PBM Plus.
PBM Plus partners with clients to develop and provide customized solutions that help plan sponsors continue to offer affordable and cost-effective prescription benefits.
Our unbiased consultative services (offered at no cost) help plan sponsors manage this complex health care benefit.
Access To Pharmacy Services
PBM Plus has contracted a national network of participating retail pharmacies comprised of all major national, regional and local pharmacy chains, including traditional
drug stores, mass merchants and food/grocery. Most independent pharmacies participate in the national network. We can also quickly contract with pharmacies as needed, to
provide convenient access to all our members.
A fully integrated mail order option is available along with our national pharmacy network. The mail order pharmacy provides the convenience of home delivery for maintenance
medications and additional savings opportunities.
Access To Drugs
A formulary is a list of preferred drugs that have been proven as safe and effective. All PBM Plus formulary products are FDA approved and include both brand name and generic
drugs. PBM Plus uses a formulary philosophy, based on achieving the lowest net cost to the employer for the best therapeutic products.
Specialty drugs (high cost injected, infused and biotech drugs) are now frequently used in the course of treatment for many high cost diseases. PBM Plus has developer a
specialty drug program to obtain the best discounts available on these high cost products and deliver disease management for patients affected by these high cost diseases.
Access To Support
PBM Plus has dedicated customer service representatives to assist our clients, members, participating pharmacies and prescribing physicians 7 days a week. At PBM Plus our customer
service representatives are trained to answer questions and resolve issues regarding eligibility, coverage, plan design, claims payment, retail and mail service prescriptions.
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