Blue Cross, PBM execs offer approaches to generic-drug inflation
Steve Johnson, senior health-outcomes director at pharmacy benefit manager Prime Therapeutics, LLC, told the AIS Report that tactics the PBM is considering or implementing include creating new cost-share tiers for high-cost and low-cost generics, increasing the use of preferred-pharmacy networks and implementing utilization management programs to target high-cost generics.
Prime coordinates care for 26 million members, and generic prescriptions represent more than 80 percent of all prescriptions, Johnson said.
“We will continue to closely monitor generic-drug pricing to provide the best care and value to members,” Robert Giles, Jr., manager of formularies at BlueCross BlueShield of Tennessee, said. “In some cases, this could mean particular generics either aren’t added to our formulary, or some could be removed if there are alternative products with more reasonable pricing.”
visit http://aishealth.com/archive/nblu0715-02 to read the entire newsletter.