The Emerging Technology, Data Introducing Accountability in the PBM Industry

Over the years, according to many experts and industry professionals, the largest pharmacy benefit managers (PBMs) have aggressively acquired pharmacy-related businesses to grow their portfolio and garner massive market control. Amid what experts refer to as a CVS Caremark-Optum Rx-Express Scripts triopoly, drug supply chain entities focused on patient care, engagement, and costs are utilizing data and technology to set themselves apart from the “Big 3” PBMs.

“It's refreshing to see the traction. Obviously, competition is good. I don't expect the Big 3 to go away,” Bill Wolfe, COO at WriteWise and former President of Aetna’s Pharmacy Management team, told Drug Topics. “They have the infrastructure and the wherewithal and the balance sheets to continue to play a role in the space. Their integrated offerings do have some value, but I think that having some transparency and really focusing on patient engagement, as well as focusing on the outcome and on managing costs at the same time that you're managing quality, is gaining traction.”

It may seem surprising to read that a focus on patients’ engagement and improving their outcomes is “gaining traction.” However, what Wolfe means is that the PBMs that focus on those paramount factors are gradually gaining visibility, making patients, payers, and pharmacists lean more toward grassroots PBM movements rather than those like the Big 3.

Wolfe joined Drug Topics for the most recent episode of Over the Counter to discuss persistent issues and challenges in the PBM space, his company WriteWise, and what he and his team are doing to support a variety of stakeholders in both the drug supply chain and the pharmacy industry.

Stay tuned for weekly podcast episodes of Over the Counter powered by Drug Topics every Thursday afternoon. Also, be on the lookout for bonus episodes like this one throughout the year! Check out our most recent bonus episode with Pooja Babbrah from the National Council for Prescription Drug Programs (NCPDP): How Pharmacy Standards Drive Efficiency, Safety, and Savings.

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