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