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Episode 13: A Refreshing Look at Pharmacy Benefits (Part 2)
Manage episode 313694752 series 3282256
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00:00 Intro
00:40 Vinay Patel of Self-Insured Pharmacy Networks
01:25 In last week's episode
02:38 A day in the life of a community pharmacist
03:32 Pharmacists in a big box format want to cater to patients just like community pharmacists do
03:53 We're replicating the same model on the pharmacy side as DPC has done on the medical side
04:41 Care coordination needs to happen all throughout the local care team (healthcare supply chain)
05:41 Community pharmacist is just that--part of the community
07:00 More tools, more attention to detail, more customization
07:38 Less overspending, overtreatment, example = mail order
07:58 Smaller is better, especially if you're trying hard not to overspend
12:00 Is mail order even all it's cracked up to be?
14:30 Those dealing with healthcare challenges could benefit by having another member of the local care team to help "tag team" with the physician
18:24 When you have a chronic disease you need high-touch support and accountability
19:00 Getting back to the basics might not be a bad thing
20:00 We drifted away from relationship-based primary care but we're coming back to it
20:32 www.sipharmacynetwork.com, Self-Insured Pharmacy Networks based in Raleigh, NC
21:00 vinay.patel@sipharmacynetwork.com
21:41 No one definition of "specialty drug". The definition your PBM gives it is in your contract
22:15 Get an actual list of what specialty drugs are on your formulary
22:26 Make sure you ask lots of questions
22:47 There shouldn't be any generic drugs in the specialty category
23:37 Allocate much more time to the PBM contract
25:00 Spend more time to the upfront education about the prescription drug benefit and what goes into that design
27:00 Crawl, walk, run strategy
28:30 Employers need a co-fiduciary to be their partner
30:00 Carriers glossed over Rx like there was "nothing to see here"
31:00 Rockford, IL story
32:00 You MUST read your PBM contract
33:43 This is people's lives we are dealing with
34:00 Municipality resources are deficient today because of the drainage into the healthcare system
35:00 Thank you, www.custombenefits.work, #letsfixhealthcare
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