Videos

Capital Rx President Matt Gibbs breaks down drug price indexes, including problems with them, and what plan sponsors/payers should be thinking and asking about during contracting.

On May 23, 2022, Capital Rx’s Chief Growth Officer, Kristin Begley, was joined by an exceptional panel of experts on stage at thINc360.

Thanks to Jessica DaMassa and WTF Health for having Capital Rx Co-Founder & CEO, AJ Loiacono, on for a great discussion about the evolution of the pharmacy benefit management (PBM) and pharmacy benefit administration (PBA) models!

Do you have a copay-card program in place? If so, your PBM may be reaping tremendous hidden profits off of it. So go ahead, ask your PBM to disclose all of their fees for this program… but be ready for some sticker shock.

If your PBM owns a retail or mail order pharmacy, they’ve probably encouraged you to turn on an “auto-refill” feature for your plan. But did you know that this feature can leave patients with more drug quantity than they can actually use in a given year? Guess who’s paying for all that excess supply…

Your PBM probably tells you they’re saving you money with prior authorizations, but when is the last time you looked at your actual PA approval rates? PBMs that profit from dispensing tend to “leave the gate open” when managing PAs.