Episode 13: A Refreshing Look at Pharmacy Benefits (Part 2)

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  [email protected]

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