For the first time in six years we asked for bids on our prescription drug benefit. Walgreens Health Initiatives (WHI) has been our provider and is one of four finalists. The technical name for prescription drug providers is Pharmacy Benefit Managers or PBM's. What they do is administer drug benefit programs for employers and health insurance carriers. 95% of all patients (200 million Americans) with drug coverage receive benefits through a PBM. The largest companies are:
•AdvancePCS
•Caremark Rx
•Express Scripts
•Medco
•WellPoint
•MedImpact
The bid award winner of the City's prescription drug administrator will be formalized at the council meeting on May 15th.
The TSA will hold a brown bag seminar soon after for anyone interested in learning more about our prescription drug benefit. I know a lot of you have concerns as well as specific complaints regarding prescription drugs. I think you will find it worth attending. Understanding why plans are structured they way they are can help provide you with the knowledge you need to make rational decisions about your drug therapy.
Here are the topics we will cover:
- What is a formulary?
- How much do we save using generics?
- How much does mail order save compared to using pharmacies?
- What is step therapy?
- Are new drugs really new or are they minor variations or duplicates of drugs already on the market?
- What is a Tier 3 plan?
- What we currently spend on the following drug categories: Oncology/Immunity, Cardio- Vascular, Pulmonary, Neuro-Psychological, Gastro-Intestinal, Rare and Specialty.
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