Topics: 

• Evidence-Based Pharmacy Risk Management
• Misaligned Incentives
• Specialty Drug Management
• Rebate Chasing
• Prior-Authorization
• Formulary Management
• Reference based pricing

In this episode, Michael introduces you to Tery Baskin, PharmD, Founder & CEO of RxResults.  Join us as we discuss the misaligned incentives that may exist in typical Insurance Carrier and PBM formularies and how proper formulary management can drive significant savings for an employer.

Here’s a glance at what we discuss in this episode:

• Tery Baskin’s background and how he launched RxResults
• Understanding the left and right side of the Healthcare equation
• The Rebate “sleight of hand” and Rebate Chasing
• Pharmacy Benefit Manager Contracts and what to be aware of
• How Pharmacy Benefit Managers controlling the prior-authorization process for drugs distributed through their own specialty pharmacies may constitute a conflict of interest
• How drug manufacturers and PBM’s may use the FDA “safe and effective” label to promote utilization of expensive drugs over lower cost drug therapies
• How reference based pricing works within a formulary and can drive 12-17% savings in pharmacy spend
• How RxResults can help Physician groups at risk for Pharmacy spend
• Independent prior-authorization and how may help decrease specialty pharmacy spend by 20%
• How formulary management can help employers avoid wasteful spending on expensive drugs that don’t provide better results than lower cost therapeutic equivalents
• Why some Pharmacy Benefit Managers may not allow Formulary Management to be carved out
• What the fee structure is for RxResults and the typical ROI that an employer would achieve
• RxResults website: https://rxresults.com/