Episode 13: A Refreshing Look at Pharmacy Benefits (Part 2)

00:00 Intro00:40  Vinay Patel of Self-Insured Pharmacy Networks01:25  In last week's episode02:38  A day in the life of a community pharmacist03:32  Pharmacists in a big box format want to cater to patients just like community pharmacists do03:53  We're replicating the same model on the pharmacy side as DPC has done on the medical side04:41  Care coordination needs to happen all throughout the local care team (healthcare supply chain)05:41  Community pharmacist is just that--part of the community07:00  More tools, more attention to detail, more customization07:38  Less overspending, overtreatment, example = mail order07:58  Smaller is better, especially if you're trying hard not to overspend12:00  Is mail order even all it's cracked up to be?14:30  Those dealing with healthcare challenges could benefit by having another member of the local care team to help "tag team" with the physician18:24  When you have a chronic disease you need high-touch support and accountability19:00  Getting back to the basics might not be a bad thing20:00  We drifted away from relationship-based primary care but we're coming back to it20:32  www.sipharmacynetwork.com, Self-Insured Pharmacy Networks based in Raleigh, NC21:00  [email protected]:41  No one definition of "specialty drug".  The definition your PBM gives it is in your contract22:15  Get an actual list of what specialty drugs are on your formulary22:26  Make sure you ask lots of questions22:47  There shouldn't be any generic drugs in the specialty category23:37  Allocate much more time to the PBM contract25:00  Spend more time to the upfront education about the prescription drug benefit and what goes into that design27:00  Crawl, walk, run strategy28:30  Employers need a co-fiduciary to be their partner30:00  Carriers glossed over Rx like there was "nothing to see here"31:00  Rockford, IL story32:00  You MUST read your PBM contract33:43  This is people's lives we are dealing with34:00  Municipality resources are deficient today because of the drainage into the healthcare system35:00  Thank you, www.custombenefits.work, #letsfixhealthcare