Good morning!
Cold enough for you? Not that this was ever funny but it sure
isn’t right now. The temperature (and wind chill) are facts. You
can measure them accurately using a standard scale and get no
argument when you report the number. The key to how cold you
feel is the degree to which you prepare. When “Winter
camping” we bring clothes made for cold temperatures and plenty
of them. We bring boots and sleeping bags rated for cold
temperatures and plan meals and activities to keep our body
temperature comfortable. “So how does this apply to
pharmaceuticals ?” you might ask. (or “Has the cold affected his
brain?” might be the other question.)
Well we see the pharmaceutical forecasts (High cost injectable
pharmaceutical on the rise with a huge high pressure area coming
in from the retired members, A blizzard of political rhetoric on
the horizon accompanied by a lot of hot air.)
If you haven’t been planning for this storm you may still have
time. Evaluate your prior authorization program, institute
mandatory generics and a stepped approach to using high cost
drugs. Prepare for the high cost injectables. Your highest
users (the 5% who use 50% of your assets) may benefit from
closer scrutiny of all of their drugs and some may benefit from
care management.
I doubt that the warming of the US economy will obviate the need
to plan and then take action. Members are lined up at the
pharmaceutical ticket counter expecting you to pay 80% of their
pharmaceutical trip to a warm comfortable place. Use the PBM
tools you have to prepare your plan for the future storms you
know your company will have to weather in order to remain
viable. You can plan ….or get lost in a hot toddy by the
fireside while looking at the want ads.
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