Dr Glenn Stettin Outlines the Importance of Transparency for PBMs

Being transparent is important for pharmacy benefit managers in order to know what the criteria are for coverage, said Glenn D. Stettin, MD.

Being transparent is important for pharmacy benefit managers in order to know what the criteria are for coverage, said Glenn D. Stettin, MD.

Transcript (modified)

How can pharmacy benefit managers be more transparent and how does it benefit them to do so?

I don’t know that I can speak for the industry, but I can say that at Express Scripts it is important for us, for physicians, to know what the criteria are for coverage, specifically for the plans where we manage the prior authorization process. So we make that information available that physicians can find it, and then the other areas in what drugs actually cost. One of our recent introductions is the pricing tool and mobile application for our patients, where they can actually put in the name of a drug and look it up to find what that medication would cost at the pharmacy and at different pharmacies — because sometimes different pharmacies have different pricing. Or it doesn’t help yet and we need to do more are for drugs that are billed under the medical benefit as opposed to the pharmacy benefit. And I think that we have some good plans in place to make that kind of pricing transparency available, as well.