What are Pharmacy Benefit Managers (PBMs)?

Pharmacy Benefit Managers, or PBMs, are companies that manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers, and other payers. Depending on their service, PBMs work on behalf of their clients to negotiate lower prices with drug manufacturers. PBMs currently fall into one of two main categories: traditional pharmacy benefit managers or transparent pharmacy benefit managers, each with different means of profit.

Traditional Pharmacy Benefit Managers

Differential pricing is currently one of the primary methods by which traditional PBMs profit. According to the Centers for Medicare & Medicaid Services, differential pricing occurs when health plans contract with PBMs to manage their prescription drug benefits, and PBMs keep a portion of the amount paid by health plans. for prescription drugs instead of spending the full payments. at pharmacies. Many traditional PBMs also benefit from rebates and rebates provided by drug manufacturers rather than passing all savings on to customers.

Transparent Pharmacy Benefit Managers

In contrast, transparent PBMs such as SpectrumPS operate on the basis of actual costs rather than differential pricing and withholding discounts. Under the seamless model, customers choose to contract with their PBM to have predictable drug costs for the year by choosing to pay the price the PBM has negotiated with pharmacies plus a separate administrative fee for services returned.

Transparent PBMs also share data with end users, simplifying prescription drug management and building trust in business decisions made with and on behalf of customers. SpectrumPS is attractive to many customers because of its predictable drug cost structure, data sharing to make informed healthcare decisions, and lack of differential pricing.

Spectrum Pharmacy Solutions

Spectrum Pharmacy Solutions (SpectrumPS) is a premiere pharmacy benefit manager that specializes in hospice care to ensure that your patients are able to experience the very best level of long-term care that they deserve when they need it the most.

For us, after patient care, nothing is more important than working to keep the operating costs of our clients low through multiple scalable models that seamlessly align with the needs of your hospice. We’ve worked to develop an extensive network of hospice-specialized pharmacies, so that your patients can receive their medications from a local long term care pharmacy in their neighborhood. You see, hospice care and long term care shouldn’t have to be difficult – care providers should be able to seamlessly receive the medications and prescriptions that they need for their patients from a trusted pharmacy without outrageous costs, slow service, and poor support. And here at SpectrumPS, we’re making it all possible by becoming your dedicated, trusted, and proven partner.