Prioritizing Patients over Profits: A Comprehensive Guide to Evaluating Your PBM’s Commitment to Patient-Centric Health Care
In the intricate web of health care management, the role of Pharmacy Benefit Managers (PBMs) has become increasingly pivotal. These entities significantly influence medication accessibility, treatment options and the overall health care experience.
However, not all PBMs are created equal, and discerning whether your chosen PBM genuinely prioritizes patients over profits is essential for fostering a health care environment that truly serves the individuals it’s meant to care for.
Formulary Management: Where Patient-Centric Health Care Begins
One of the clearest indicators of a PBM’s commitment to patients over profits lies in its formulary management. Take a closer look at the medications listed in the formulary.
Is there a comprehensive range of options encompassing generic and brand-name medications?
A PBM that prioritizes patient-centric health care has a meticulously curated formulary to offer the most cost effective and clinically-effective choices. Prioritizing generic medications not only reduces costs for patients but also emphasizes a commitment to providing treatments based on proven efficacy rather than brand affiliations.
Patient Navigation Team: Advocates for Member Well-Being
A robust patient navigation team distinguishes patient-centric PBMs. These teams advocate for your members, offering various invaluable services beyond administrative assistance.
When evaluating your PBM, inquire whether their patient care/navigation team offers comprehensive support, including medication assistance, adherence support, prior authorization guidance, benefits advice and even financial assistance programs. A PBM that prioritizes patients over profits recognizes the holistic nature of patient care and provides avenues for members to access the support they need to navigate their health care journey seamlessly.
Transparent Pricing Models: Fostering Trust Through Clarity
Transparency is the cornerstone of patient centric health care. A PBM that values patients over profits ensures its pricing models are clear and easily understandable.
Consider whether your chosen PBM fosters transparent communication with employees and members regarding pricing structures. A transparent PBM takes the time to break down pricing components, helping employers understand the costs associated with their medications and treatments.
AffirmedRx: Prioritizing Patients over Profits
The distinction between a profit-driven PBM and a patient focused one lies in the attention to detail, the scope of services offered and the level of transparency maintained.
AffirmedRx is dedicated to prioritizing patients over profits. With our unique status as the only PBM structured as a Public Benefit Corporation (PBC), our business model is designed to align with the well-being of American families. Our investment and executive compensation structures further reinforce this commitment, prioritizing ethical business practices.
AffirmedRx is a pharmacist-led organization at our core, reflecting dedication to patient well-being. Our waste-free formulary and pursuit of the lowest net cost by indication underscores our commitment to quality care that doesn’t compromise efficacy.
Through our Patient Care Advocates (PCAs), we offer personalized support that empowers patients to navigate the health care landscape without disruption – emphasizing assistance, adherence and overall well-being.
See the difference in patient-centric health care and PBM solutions with AffirmedRx.