Overview of Prescription Coverage
Managed care companies are still struggling with the rising costs and utilization of Specialty Drugs.
Why is this still a challenge? There are many answers, one of which is the counterproductive use of the PBM (Prescription Benefit Manager) as the pharmacy provider.
Nearly all Managed Care organizations use a PBM to administer their Prescription Benefits. However, these PBM’s are also operating as Mail Order pharmacies.
Is this a problem? Not necessarily. Mail order pharmacies are great resources for medications that are needed long term and where compliance is not going to be a challenge. However, Specialty Medications require special care, care that helps patients adhere, comply and achieve the desired therapeutic outcome.
PBM’s are paid to manage the members benefit, whether the member is on medication or not.
So the necessity of compliance is in question.
If a patient receives 90 days of drug the patient looks to be compliant to the managed care company for those 90 days. However, with the highest rate of non-compliance falling in the first 90 days there is a greater chance of non-compliance, which leads to increased MD visits, alternate medications and even hospitalization.
Who provides the best VALUE for specialty drug care?
BioPlus Outstanding
Reviews
BioPlus 2nd Quarter surveys are in and the results are high praises from physicians offices across the country.
BioPlus has achieved 100% good or excellent rankings by physicians and patients.
With physicians noting our service level to be a key to their practice management.
INFORMATION YOU WOULD LIKE US TO REVIEW?
 If you are seeking information or have a topic that you would like us to
review or research or have an idea that you would like to share that can help the community, please drop us a line at
info@bioplusrx.com.
BioPlus Specialty Pharmacy has been dedicated to chronic illness care for over 20 years.
Our goal is to provide the best care and resources we can to all those seeking assistance.
From patients and their families to prescribers and their staff to healthplans and manufacturers.
So, please share your comments, ideas or stories with us. You never know who you may be helping!
Here’s to a healthier tomorrow!
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