PBMs: The Savings Generator

Host JC Scott speaks with Mark Newsom, the principal and founder at Health Evaluations LLC, on the core role of Pharmacy Benefit Managers (PBMs). Newsom goes through the process PBMs take to get us, the consumers, the most effective medications for the lowest premiums. He also discusses PBMs and their role in conjunction with the other players in the industry. Some key points from the conversation include:

Why PBMs Exist And How Savings Are Generated For The Consumers: Newsom accentuates how PBMs’ role in doing the formulary is one of the biggest steps in reducing costs of prescriptions while also increasing the safety of the consumer. He also focuses on how negotiations between manufacturers and pharmacies is a key area for lowering prices. These savings from each individual step help consumers save 40-50% on their annual costs in the form of lower premiums.

A Breakdown Of Where The Money Flows And The Thin Line Of Profit PBMs Tread On: JC Scott breaks down the purchasing dollar and where it goes within the pharmaceutical industry and questions Newsom about the low profit margins of PBMs. Newsom explains how much money is saved for every dollar spent on PBMs, and how even a low percentage of the total money involving pharmaceutical drugs goes a long way when there are billions of prescriptions every year.

What Actions Undermine The Work Of PBMs: Newsom discusses how everyone wanting everything hurts the effectiveness of PBMs working to get people quality prescriptions at lower costs. With individual preferences and politics getting involved, PBMs must work around these obstacles in order to provide the best service they can.

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