Article

Raulo S. Frear, PharmD, Says How PBMs Are Aligning Benefit Designs for Delivery System Reform

Raulo S. Frear, PharmD, general manager, OmedaRx, says pharmacy benefit managers are aligning benefit designs for delivery system reform in a few ways. With respect to the delivery system reform, if you look at ACOs as a specific example, our experience has been that the ACOs are not really ready to talk about different benefit designs, Dr Frear says. They're still learning what it means to accept risk and that means risk across a lot more areas than just pharmaceuticals.

Raulo S. Frear, PharmD, general manager, OmedaRx, says pharmacy benefit managers are aligning benefit designs for delivery system reform in a few ways.

“With respect to the delivery system reform, if you look at ACOs as a specific example, our experience has been that the ACOs are not really ready to talk about different benefit designs,” Dr Frear says. “They’re still learning what it means to accept risk and that means risk across a lot more areas than just pharmaceuticals.”

He adds that over time, as various programs are put into place, and as evidence of these programs affecting cost emerge, reform will naturally lead to different types of designs in benefits, formulary, or utilization management tools.

Newsletter

Stay ahead of policy, cost, and value—subscribe to AJMC for expert insights at the intersection of clinical care and health economics.

Related Videos
Dr John Mascarenhas
Dr Pankit Vachhani
Merrill H. Stewart, MD
Dr John Mascarenhas
Dr John Mascarenhas
Dr Xavier Leleu
Dr Xavier Leleu
Francesco Sparano, MSc
Dr Sundar Jagannath
Dr Ashley Yocum
Related Content
AJMC Managed Markets Network Logo
CH LogoCenter for Biosimilars Logo