What do PBM pharmacists do?

According to the United States Bureau of Labor Statistics, most pharmacists practice in a retail or hospital pharmacy. Since pharmacy benefits manager (PBM) jobs are relatively rare, most pharmacists don't know what it's like to work for one.

In a 2013 survey by the American Pharmacists Association, pharmacists employed by PBM found the following aspects of the job most appealing: interaction with customers, ever-changing issues and challenges, flexible hours, research and evaluation of clinical studies and peer-reviewed literature. possibility of moving from a profession of pharmacist to a profession of service provider.

These same PBM pharmacists found the following aspects of the job less appealing: sitting at a desk 8-10 hours a day and performing daily tasks like answering emails, statistics, and paperwork. Another frequent concern of these pharmacists was the lack of direct contact with the patient.

Mail-order

In my experience, this is the most well-known aspect of PBM jobs. Many employers require their employees to use mandatory 90 day mail-order services for their long term medications. Mail-order pharmacies account for approximately 19% of all outpatient prescriptions filled in the United States.

Mail-order pharmacists typically work in large centers and translate scanned images of prescriptions into the ordering system. These prescriptions are then filled by automated dispensing system. Mail-order pharmacists perform a drug utilization review (DUR) and call prescribers to clarify prescriptions.

In my opinion, one of the most difficult aspects of filling prescriptions by mail is the lack of context. You fill a prescription written by a prescriber you don't know for a patient you've never seen.

Call center

Pharmacists who work in a call center perform a variety of functions, such as calling prescribers, administering drug therapy (MTM), disease management programs, and consulting patients. Call centers also manage and process prior authorization requests.

Office environment

Many PBM pharmacist positions are performed in an office environment. Here is a short list of possible roles:

• Forms management

• DUR (prospective, concurrent, retrospective)

• Drug information

• Fraud and Abuse Programs

• Usage management (pre-authorization, step therapy, limits, position limits)

• Quality assurance

Customer Service/Account Management

These pharmacists work directly with clients to discuss the design of the client's plan benefits (formula, utilization management, etc.). They allow their clients to customize clinical and reporting requirements to meet the needs of their individual population and to assess the suitability of new drugs.

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