Thursday Feb 02, 2023

Pharmacy Benefit Managers, Part 2

Pharmacy Benefit Managers (PBMs) have emerged as a powerful player in healthcare today, and their role has brought value but also controversy. They have become a negative challenge for many provider practices Yet, there is a different approach that is more provider-friencly, and on this episode, we explore the approach of Alluma as an alternative to PBMs.

Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient

Guest:
Priyesh Patel, PharmD, MBA
Vice President and General Manager, Alluma
Vizient

Show Notes:

[00:51] Role of PBMs: value and controversy

[02:53] Alluma: a different PBM approach

[05:33] PBMs and lagging rebates: a disconnect for health plans

[06:58] Best practice: a provider-led solution

[09:27] PBMs and thwarted access to preferred medications

[10:44] A limited PBM appeals process

[11:19] Alluma’s approach: working more closely with providers

[11:40] Addressing regional prescribing patterns

[15:20] The future: more government regulation