Pharmacy Benefit Management Strategies
Why is it so
crucial to offer the right pharmacy plan benefits?
The value of drugs in overall
health management is unquestioned, yet the increasing cost of
providing this benefit presents a significant concern for employers.
The annual double-digit increases in drug costs is largely due to the
introduction of newer drugs that are extremely expensive and often
heavily advertised, increasing rates of drug utliization and drug
price inflation. Experience has taught us there is no single strategy
for controlling the rise in drug costs. Efforts to maintain
affordability of the prescription benefit must be multi-faceted, and
each component of the process must be of high quality and receive
constant attention. Fundamentally and highly inter-related elements of
effective drug use management that must be considered include:
Benefit design
Formulary management
Education
Reporting data and sharing information
What We Offer
More than 50,000 PCS
network pharmaciesDedicated pharmacy benefit management staffFast claims processing and paymentFormulary designed and managed by physiciansExceptions to formulary reviewed and approved by local pharmacistsRx Case management program for complex and high-cost medical
conditionsRx Disease Management Program for chronic health conditionsRx Utilization program, including custom, monthly reports to
physicians, detailing high-utilization patients and those receiving
controlled substances and headache medicationsEducational seminars for physicians and other health care
professionals, as well as for employees
How We're Different
St. John’s pharmacy benefit strategies follow the rules of effective
drug use management and are driven in large part by physicians.
Formularies, for example, are all designed and reviewed by physicians.
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