AH035 - Pharmacy Benefits 101: Clinical Programs, with Bonnie Hui-Callahan, PharmD

In this episode of the Astonishing Healthcare podcast, Justin Venneri speaks with Bonnie Hui-Callahan, PharmD, CDCES, Senior Director of Clinical Programs at Capital Rx, about the significance of clinical programs within the pharmacy benefit management (PBM) space. Bonnie explains how clinical programs serve as an "added layer of service" similar to after-school programs. They enhance the core functions of PBMs (claim administration) and help plan sponsors reduce costs, improve quality of care, enhance patient safety, and address prevalent health conditions within their populations.The conversation delves into the different types of clinical programs offered by Capital Rx, categorized into five key areas: utilization management, cost containment, patient safety, population health, and personalized care. Bonnie emphasizes that while many programs, such as opioid safety and medication therapy management, are standard across PBMs, there are also unique, in-house, and vendor-partnered solutions tailored to specific health conditions. She also highlights the potential benefits and importance of integrating pharmacy and medical claims, offers some key questions plan fiduciaries can ask, and reviews the results of a recent poster presentation by her team at the 2024 Pharmacy Quality Alliance meeting!Related ContentPoster: Impact of Point-of-Sale Duplicate Therapy Safety Alert on Concomitant DPP-4 Inhibitor and GLP-1 Agonist UseAH005 - Star Ratings, MTM, & CMS Translation Requirements with Jay Tran, PharmDAH006 - Pharmacy Benefits 101: Clinical Care Teams, with Amy Stockton, PharmDPharmacy Benefits 101: Prior AuthorizationsFor more information about Capital Rx and this episode, please visit Capital Rx Insights.