The pharmacy benefit manager plays a vital role in helping to contain the cost of prescription drugs-for both consumers and health insurance payers-in the current US health care system. One way benefit managers do this is by setting up and managing a drug formulary for their customers.
A formulary is basically a compilation of prescription drugs and to what degree they are protected by a specified health care plan. The pharmacy benefit manager establishes the formulary for a wide range of medical conditions by assessing the effectiveness, safety and cost of each drug. Highly effective and cost-effective medicines are typically included in the process, whereas unproven or excessively costly drugs may be omitted.Get the facts about You may find more information at Baton Rouge Pharmacy Benefit Manager.
Once a type is developed, the benefit planner may also assist in establishing standards for the retail costs of each medication for the patients. Consumers will pay lower prescription co-payments in many plans for drugs which are on the form of a plan than for drugs which are not. And in a few isolated cases, customers might have to pay up to 100 per cent of a non-formular drug’s expense.
While this may sometimes be expensive for a small number of individuals, formulas do help to keep down the overall cost of prescription drugs by encouraging the most effective, least expensive drug use wherever possible. A professional pharmaceutical benefit planner must work diligently to insure all products include at least one medication for each disease (or product class) and, when possible, would promote the best cost savings by using generic drugs.