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Monday, September 23, 2013

3:45 p.m. - 4:30 p.m.
Track: Regulatory & Compliance View Track

PRESCRIPTION DRUG MANAGEMENT (PDM) TRANSPARENCY: FACT OR FICTION

Scott Haas, VP, Integrated Health Metrics, WELLS FARGO INSURANCE

Transparency generally, implies openness, communication, and accountability. Transparency is operating in such a way that it is easy for others to see what actions are performed. Unfortunately, within the PBM industry, the term transparency does not always meet the spirit of this definition and many plan sponsors find the cost of their prescriptions drugs are inflated well beyond the cost actually being paid to pharmacies. It doesn't matter if your health plan is self-insured or fully-insured through a carrier, PBM pricing spread exists in most all situations and the level of prices being charged many times is creating financial barriers to patients who are dependent on their prescriptions to maintain a positive health status.

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