Archive: Pharmacy Benefits Consulting

  • August 5, 2020

    The Gist of J Code Drugs

    The way drugs are billed when they are dispensed by a doctor’s office or an infusion center is different than drugs purchased from a pharmacy–and a lot more expensive.

  • August 3, 2020

    What’s Going on with the Largest Pharmacies and Pharmacy Benefit Managers?

    There’s a lot of talk about vertical consolidation of healthcare plans with PBMs. But have you considered what this means for the 10 largest ones?

  • July 29, 2020

    Open to Closed: The Difference in Pharmacy Formularies

    There are two basic drug formularies pharmacy benefit managers offer to self-funded employers: open and closed. Knowing the difference can save you money.

  • July 20, 2020

    Pharmacy Compliance and Adherence Packaging: Making Meds Easier

    There are pharmacies that provide something called Pharmacy Compliance Packaging, which is all the medications a patient takes put into blister packs they can tear off and take at different time points during a day.

  • July 6, 2020

    Wee Dose of Radical Transparency | EP 7

    You know when your prescription drug is dispensed at the counter, it is paid usually in the form of a co-pay. You also understand the PBM determines how much you pay the pharmacy. But what do those pieces mean to …

  • June 15, 2020

    How Do You Curb Specialty Drug Spend?

    Drugs can become “specialty drugs” because of the way they are manufactured, distributed, or treat rare disorders, among other reasons. Specialty drugs are expensive, and they can quickly wreck a pharmacy benefit budget, too. Just one specialty drug could cost …

  • June 5, 2020

    Where is Your Drug Spend Headed in New FDA-Approved Therapies?

    Looking at the calendar, 2020 is nearing the halfway point. While many may not be sad to see this year go, one thing we like to do here at Apex in the pharmacy benefits team is pause and review new …

  • May 14, 2020

    PBM: Deal or No Deal? No Deal…

    Has your broker presented a PBM solution that has no Administrative Fee? Or, presented a PBM with a $1 or $2 Administrative Fee and positioned it as competitive? Read more.

  • May 12, 2020

    Wee Dose of Radical Transparency | EP 6

    A PBM offer that offers an administrative fee of just $1 or no fee at all may sound good, right? Think again. Apex Executive Advisor Scott Long will explain why you should run the other way if you receive a …

  • May 6, 2020

    65,000 Pharmacies – Really?!

    Have you ever considered for a moment that most traditional pharmacy benefit manager contracts provide access to 65,000 – 70,000 pharmacies? 

  • May 1, 2020

    Wee Dose of Radical Transparency | EP 5

    Traditional PBMs want to give clients as much exposure to pharmacies as possible. Why? They’ll have endless opportunities to charge you one price, and a pharmacy a lesser price. Apex Executive Advisor Scott Long will detail how you can take …

  • April 29, 2020

    At What Point Do You Say, “Enough is Enough”?

    I’ve also mentioned, that because of traditional PBMs incentive to maintain status quo, they will provide transparency and disclosure only as demanded by clients – you the plan sponsor.

1 3 4 5 6 7