A blueprint for pharmacy benefit managers to increase value.
Pharmacy benefit managers (PBMs) have a unique opportunity to promote health and generate value in the healthcare system. Today, PBMs are largely evaluated on their ability to control costs rather than improve health. Pharmacy benefit managers should be evaluated along 3 dimensions in which they can increase value: (1) use of cost-effective medications, (2) timely initiation of appropriate medication therapy, and (3) adherence to that therapy. Value creation requires the development of integrated data systems, stronger partnerships with patients and physicians, and improved measurement and reporting of results. Incentives for PBMs to promote value should drive innovation and improve health outcomes.
Shrank
William H
WH
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, 1620 Tremont St, Ste 3030, Boston, MA 02120, USA. wshrank@partners.org
Porter
Michael E
ME
Jain
Sachin H
SH
Choudhry
Niteesh K
NK
D003363:Cost Control; D003362:Cost-Benefit Analysis; D006264:Health Benefit Plans, Employee; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D055118:Medication Adherence; D010605:Pharmacy Administration / Q000191:economics*; D011785:Quality Assurance, Health Care; D013997:Time Factors