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Amen! Finally, a physician on record not pointing the finger and accepting some accountability. That being said, PBMs too must continue to work on making the process of filling prescriptions more efficient and transparent. Employers and brokers alike should also recognize that with rising drug costs, formularies become more restrictive to offset those rising costs.
A tightly managed formulary doesn't mean it is less effective, necessarily. In fact, the opposite is usually true. Employees achieve similar outcomes at lower costs with tightly managed formularies. If a tablet form is significantly less expensive than a capsule, the tablet is covered while the capsule is not, for instance.
She encouraged attendees to create systems and processes to streamline addressing drug denials, prior authorizations and the review of alternatives. “We have to create systems in our organizations to better understand this process,” she said.
“If you look at the struggles taking place, ... we can’t get the right prescriptions to the patients a lot of the time. New drugs are coming out and new things are getting approved, and we know the patients need them. My senior physician likes to say the prescribing of drug is just a suggestion these days – it is not an order.”
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