Medical and Pharmacy Drug Management
Overview
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.
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.
Medical and Pharmacy Drug Management Resources
The National Alliance supports policies to reduce prescription drug costs for all purchasers while encouraging meaningful innovation. These resources support employers/purchasers in injecting greater competition, transparency and value into pharmacy and medical drug management.
Employers Beware: Alternative Funding Programs Require Careful Review to Avoid Negative Consequences
As healthcare costs increase, employers/purchasers continue to explore strategies to better manage pharmaceutical costs. One approach is the use of alternative funding programs, which are fraught with unintended consequences. “If it sounds too good to be true, it might be.
Time to Act: Understanding PBM Practices Enables Employers to Ignite Change
For the past three decades, the management of pharmacy benefits has become increasingly opaque, convoluted and misaligned. Rather than improving drug value and creating an efficient marketplace, the industry has fueled a flawed contracting model and unprecedented market consolidation. It’s time for employers to take the wheel.
Employer Playbook on Biosimilars
Employer and other healthcare purchasers grapple with how best to integrate biologics into health and pharmacy benefit plans. The National Alliance has developed this playbook to provide clear information to inform conversations with health plans and other vendor partners.
Prescription Digital Therapeutics (PDTs)
Addressing Pharmacy Benefit Management Misalignment
Employers’ Prescription for Affordable Drugs (EmployersRx)
Prescription Drug Provisions in the Inflation Reduction Act of 2022
Improving Drug Management
Opportunities in Pharmacy Benefit Management
Findings on the State of the PBM Industry
Biosimilars in the Pharmacy Benefit
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.
Related News & Resources
- National Alliance In The News
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