How Can Data Help Payers Select a Specialty Pharmacy for Their Network?

Luis Torres: “We turn data into information, and how can it be valuable information to the payer, and I work with a lot of different PBMs (pharmacy benefit managers), so how do we turn that data information down to the employer level, and ultimately the employee level? So they can actually identify when did the prescription come in, is it the right medication with the right dose, when did the patient receive it, did they receive any additional consultative services clinically to make sure that they were going to be able to tolerate the medication, and then at the end of the day, how do I report that back to the actual plan sponsor as it pertains to the coverage and the formulary support of that medication?

I think that’s one of the things that specialty pharmacies, and us an entire group, we look for ways to—how do we help turn this data and information into something that’s valuable to your plan sponsor so you can make better coverage decisions and more educated coverage decisions as it pertains to formulary tiers—primary, secondary, tertiary—and where those drugs should be placed within a coverage design?”


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