Five Hidden Costs in
Pharmacy Benefit Plans

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1Unscrupulous Drug Manufacturer Pricing Practices

Uncontrolled market forces introduce unnecessary cost and risk.
Most prescription drugs brought to market represent medical breakthroughs and priceless treatments, but some simply do not. While we can all get onboard paying for new therapies that offer life-altering and life-saving treatment options, we should take issue with drug makers using shortcut methods, like evergreening and parity pricing, to drive higher margins and capture more market share. These practices are legal, but they introduce costly, wasteful low clinical value drugs to the market, often catching employers and members unaware. Self-funded employers working hard to compete in a tough economy cannot afford to ignore these pharmacy supply chain flaws.

Impact:If not managed appropriately through the pharmacy benefit contract and targeted clinical oversight, problematic drug pricing practices present unlimited financial threat to employer-sponsored Rx plans.