Transparency for PBMs should mean more than rebate pass-through

A while back I wrote about “transparent” PBMs, which disclose and share the rebates and discounts they receive from drug makers. However, there’s still a problem with that model because the formulary is influenced by financial deals between the PBM and drug companies.

Premera Blue Cross says it’s taken the transparent model to the next level. Since 2001 Premera has taken the responsibility for formulary selection from its PBM, Medco and has audited all pharmacy claims and rebates.

Interestingly, Premera cites pharmacy cost savings –rather than more appropriate drug use– as its success metric. See ‘Transparency’ is More Than Rebates and Discounts at Premera Blue Cross at AIS Health.

June 1, 2005

One thought on “Transparency for PBMs should mean more than rebate pass-through”

  1. You’re partly correct in noting that Premera used cost savings as one success metric. But the article you link to prominently describes the primary metric: “”Premera Blue Cross Pharmacy Director Ed Wong, Pharm.D., says transparency is not just about discounts and rebates. The outcome of the transparency process, he tells DBN, should be “the right drugs preferred on the formulary.””” Hope this helps.

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