COVID-19: Pharmacy Benefit Managers Are Working for Patients


(Pharmacy Benefit Managers)

As the coronavirus takes hold in the United States and front-line health care providers are hard-pressed to treat those who are sick, pharmacy benefit managers (PBMs), along with health insurers, are working to help patients weather the pandemic.

PBMs across the board are helping patients obtain their essential medications, and supporting plan sponsors who want to waive treatment costs associated with COVID-19 care. A number of PBMs are doing more. For example, one PBM and health plan are offering an early intervention screening tool to help customers and members understand their personal risks for COVID-19.

Beyond these efforts, PBMs are collaborating with health plans and pharmacies to remove potential barriers to getting prescriptions filled by people staying at home and social distancing. Specifically, PBMs are encouraging early prescription drug refills, helping patients sign up for home delivery, and adjusting utilization management programs to minimize potential access delays. PBMs are also advising patients to adhere to guidelines issued by the Centers for Disease Control and Prevention.

This global pandemic raises the possibility of prescription drug shortages, as drugs normally used by only a few people may suddenly be needed by many, or manufacturing centers may be sidelined by virus outbreaks. PBMs, along with drug manufacturers, wholesalers and pharmacies, are integral to identifying and managing drug shortages to reduce the prospects of patients being without their prescribed medications. PBMs are closely monitoring the global manufacturing environment and using analytics to gauge patients’ prescription drug usage trends to anticipate possible disruptions to the supply chain. Then, working in concert with others, PBMs are working to help spread the existing drug supply as equitably as possible among patients who need those drugs.

Indeed, it’s vitally important during the public health crisis that all patients continue receiving access to medications, particularly those treating chronic illnesses, such as asthma and rheumatoid arthritis. As the public increasingly demands off-label use of some medications to treat COVID-19, PBMs are implementing measures that balance off-label usage with the ongoing needs of patients using on-label prescriptions for chronic illnesses. Here, for example, is how one PBM approaches this balancing act:

Decades ago, PBMs perfected home delivery of medicines for patients. While the service has always been a convenient and lower-cost option for patients to access their prescription drugs, home delivery has never been as important as it is right now. That’s why PBMs are enhancing home delivery services, as well as working with network pharmacies to provide local delivery options for consumers.

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