Have consultant pharmacists provided value to long-term care payers?
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Biomedical subjects
Publications and source records attributed to F Randy Vogenberg.
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Selecting the most appropriate therapeutic regimens is one of the most complex and critical aspects of pharmacy management today, but the process is fraught with biases. Clinical pharmacists must offer balanced and unbiased opinions concerning therapies that provide the best cost-benefit ratio for their organizations. This article describes the use of existing administrative databases to develop robust clinical resource utilization data, identify internal bias and barriers to efficient drug therapy selection, and devise medical management strategies that provide desirable clinical outcomes through cost-consequence analysis.
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For clinicians, it's tempting to draw conclusions that new medications are easier to use and monitor, are safer, and therefore result in better outcomes. Similarly, for CFOs, it's tempting to view an older medication with a lower cost as the best choice. Both physicians and CFOs need reliable data that measure the total cost of care of patients in their hospital to select the appropriate medications.
By working with pharmacy benefit managers (PBMs), employers can improve prescription drug use and thereby both reduce health care costs and enhance patient quality of care. This article educates employers about the importance of plan design in pharmacy benefits management, what distinguishes PBMs from other benefit intermediaries and how employers can evaluate and audit services provided by a PBM. Finally, it discusses upcoming changes in the drug benefit marketplace that will affect employers' opportunities and challenges in providing maximum prescription drug benefits at the best value.
Within this decade, benefit managers will see radically new diagnostics and drugs that will call for changes in drug benefit planning. This article provides insight into various value propositions that must be taken into account in a drug benefit plan, along with considerations integral to those propositions; some key trends; and the new drug pipeline. Benefit managers must remain aware of the drug pipeline and benefit trends and utilize the insight of peers or other experts in strategic benefit planning.
Higher cost medications pose a serious question for physician executives. Learn how common administrative databases can provide clinical resource utilization and identify success factors and barriers to devising cost-effective medical management strategies.