Medical and Pharmacy Drug Management
The National Alliance is addressing topics affecting the pharmacy and medical side of benefits, especially the high cost of prescription drugs, with the goal of driving better transparency and value on behalf of employers/purchasers.
Medical and Pharmacy Drug Management Resources
- Case Study, Employee Resources, Final Report, Guidebook, Issue Brief, Placemat, Playbook, Toolkit, Vendor Engagement Template, Video
The National Alliance PBM Misalignment Initiative investigates and addresses misalignment between employers and their pharmacy benefit management (PBM) service providers. Building on the 2023 PBM Playbook and other related resources, this final report […]
- Health Policy Document
The following one-page resources on 340B, PBM reform, combating high and rising hospital prices, were presented during the National Alliance Hill visits in November 2024.
The National Alliance is continuously exploring how misalignment between employer needs and PBM service provider value propositions have affected employers and other and plan sponsors. There is growing risk for […]
- Vendor Engagement Template
As the pharmacy benefit management industry undergoes the most significant transformation in decades, employers are at the forefront of driving change. This vendor engagement template equips them with information to […]
The Pulse of the Purchaser study gauges concerns and approaches of employers to address the workforce environment; whole person health, equity, women’s health, mental health and obesity management; fiduciary perspectives; pharmaceutical […]
Coalitions In Action
Membership in the National Alliance is a catalyst for state and regional coalitions and their employer/purchaser members to advance key initiatives. Together, they leverage their collective influence to drive health, equity and value.
Business Health Care Group (Wisconsin)
The Business Health Care Group (BHCG) offers a variety of employer solutions, from best-in-class strategic partners. Among these partners is Navitus Health Solutions, a transformative pharmacy benefit manager using a business model based on complete transparency and lowest net cost. AS a full pass-through pharmacy benefit solution, Navitus gives clients 100% of all rebates and any other revenue.
Purchaser Business Group on Health
To reduce healthcare costs and improve access to higher quality care, PBGH helps purchasers disrupt the complicated and opaque pharmaceutical supply chain and hold vendors accountable. The result is transformative benefit design and access to better and more transparent drug pricing for employers and their employees.
HealthCareTN (HCTN)
Pharmacy benefits continue to operate in a convoluted market, rife with disincentives, little to no transparency, and further complicated by consolidation. As specialty pharmacy continues to drive medical and pharmacy drug spend, employers are motivated to find alternatives to the status quo. HCTN introduces innovative strategies, practices and players with a goal of strengthening employer member understanding as they engage with the market.
Pharmacy and Medical Drugs
Defining and Driving Value
The National Alliance works with policymakers, employers/purchasers, and other stakeholders across the pharmacy and medical drug supply chain to influence competition, transparency, and value. Current issues of focus include pharmacy benefit manager (PBM) performance, contracting and formulary management, biosimilars, reducing waste, pharmacogenomics, and value-based benefit design.
The initiatives focus on practices affecting both pharmacy and medical benefits, with a strong emphasis on the rising costs of healthcare, hospital pricing, and prescription drugs. For example, the National Alliance has recently been engaging with policymakers to provide insights on the 340B program, its impact on escalating healthcare expenses for working families and employers, and potential areas for reform.