Pharmacy & Medical Drugs Initiative
To drive collaboration to obtain better value and support all healthcare stakeholders to align key efforts, the National Alliance is addressing a number of topics affecting the pharmacy and medical side of benefits includes contracting and formulary management, reducing waste, pharmacy benefit manager (PBM) performance, pricing inequity, personalized medicine, and value-based benefit design.
The key priorities for this initiative include developing a relevant value prop for employers on drug efficacy and safety; expanding purchaser engagement and knowledge of best practice strategies; formulary management and reduction of waste; the impact of hospital pricing practices; value-based contracting to align performance and adherence; sites of care; and evaluation of conflicting practices across the system.
Guidelines and an engagement framework, The Five Rights Framework, targets critical issues and opportunities for healthcare stakeholders including manufacturers, providers, health plans, and PBMs.
Our Path Forward
Guidelines have been integrated into our 2018 PBM Assessment, along with a new set of key principles for examining an influential drug policy from a purchaser perspective. Looking forward, we will assess our current activities and determine recommendations for employers and other key stakeholders that will address drug pricing, support better drug management care delivery.