Pharmacy Benefits

A recent report by EvaluatePharma released a list of their top drugs by projected sales in 2026. There are three big observations from this data.

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.

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?

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

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.

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 …

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 …

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 …

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 …

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 …

Pharmacy benefit managers only provide the level of transparency asked for by customers. That means some clients could have unnecessary healthcare costs, gaps in coverage and unused services. Apex Executive Advisor will explain how Apex can find those gaps and …

You don’t have to be a Fortune 500 company to receive a high-level of transparency from your PBM. Apex Executive Advisor Scott Long details how Apex can get you that same kind of transparency not just on drug costs, but …