Pharmacy Benefit Management

Most employers like their PBM, according to the 2008 PBM Customer Satisfaction Report by the Pharmacy Benefit Management Institute.

For the survey, 275 employers representing 11.3 mil­lion members ranked their PBM on three factors: overall service and performance, delivering savings as promised and delivering services as promised. Their ratings averaged a very respectable 8.0 out of 10.0, with 10 being the highest.

What to look for in a prescription drug plan:

1. Plan design:
Is the plan structured to encourage your employees to use generic, formulary or mail- order drugs? Members respond to incentives that help them save money, particularly in these economic times. Jack Bruner, executive vice president of PBM marketing at CVS Caremark, recently told Drug Benefit News, "We saw our generic substitution rate in our book of business go from 60% to 65% in the past year alone...that's quite an impressive movement."

2. Education:
Does your PBM (or its network pharmacies) provide patient education on drug dosage, use, possible side effects and interactions? Does it provide education to physicians?

3. Automatic enrollment:
Some PBMs are taking a page from 401(k) sponsors and automatically enrolling group members who need prescriptions for chronic conditions into mail order programs, unless they specifically opt out. Filling prescriptions by mail order usually costs significantly less than filling them at a retail store, and the laws of inertia say that most employees who are automatically enrolled will not bother to opt out.