Pharmacy benefit management contracting: an assessment from a recent public sector procurement experience.
In order to contain the cost of pharmaceuticals while preserving access to medically necessary drugs, Georgia state government competitively selected a single vendor in May of 2000 to manage combined pharmacy benefits under all of the state's health programs. By initiating this procedure, it intended to maximize the state's purchasing power and improve efficiency while streamlining the administrative structure. Synthesizing information from the request for proposal (RFP) and technical proposals submitted by 11 pharmacy benefit managers (PBMs) in response, we describe a model of public sector PBM contracting approach and present an assessment of the industry's service capability and performance statistics. Payers who have been using PBM services may find it interesting to compare their experience with the recent Georgia experience. Those who are considering contracting with a PBM will find the assessment of the PBM industry timely and informative.
Bae
Jay P
JP
Department of Economics, Andrew Young School of Policy Studies, Georgia State University, USA.
Justice
Paul G
PG
D003164:Competitive Bidding; D003363:Cost Control / Q000379:methods; D016527:Drug Costs; D017598:Efficiency, Organizational; D005845:Georgia; D006297:Health Services Accessibility; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics; D008484:Medicaid / Q000191:economics / Q000458:organization & administration*; D017146:Models, Organizational; D020416:Outsourced Services; D015397:Program Evaluation; D013221:State Health Plans / Q000191:economics / Q000458:organization & administration*; D014481:United States