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PBMs and Pharmacies

Pharmacy benefit companies work to provide patients with a higher quality, lower cost pharmacy experience, which includes supporting independent pharmacies in rural areas nationwide through innovative programs to increase reimbursements on prescription drugs and expanding payments for clinical services.

Each year, PBMs save patients and the U.S. health care system an average of $1,154 per person. Without PBMs, employers and health plans would be forced to go it alone on pharmacy benefits, which would result in significantly higher drug costs for patients.While PBMs are working every day to reduce drug costs for patients, PBMs are also committed to working with pharmacies to support patients’ access to prescription drugs. For example, in rural communities PBMs are offering innovative programs to support increasing pharmacy reimbursements including expanding reimbursements for clinical services performed at rural independent pharmacies for rural patients. A strong relationship between PBMs and rural pharmacies means a better experience and more affordability for patients.
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Rural Patient Population Programs

Patients who live in rural areas may have unique needs and pharmacy benefit companies have programs designed to identify and assist these patients. Analyzing patient information, pharmacy benefit companies can identify patients in rural areas who may need additional support, including connecting them to available pharmacies and other sources of clinical and social resources—for example, diaper banks and food banks—to help them lead healthier lives.

Pharmacists Are Vital Health Care Providers to Patients in Rural Areas

  • Rural independent pharmacies have different needs than pharmacies in non-rural areas, given their locations and the populations they serve.
  • Pharmacists often “practice at the top of their license,” providing a variety of clinical services that go beyond dispensing medication.

Pharmacy Benefit Companies Support Pharmacies

  • Pharmacy benefit companies support policies that enable pharmacists, where appropriate, to expand and be reimbursed for their clinical service offerings.
  • Pharmacy benefit companies are working with rural independent pharmacies to increase reimbursement to help them provide high quality care to patients.

Pharmacy Benefit Companies Partner With and Support Rural Independent Pharmacies and Their Patient Populations.

Reimbursing rural independent pharmacies at higher rates than non-rural pharmacies

Developing pharmacy networks to support rural independent pharmacies

Expanding reimbursement for clinical services performed in rural independent pharmacies

Pharmacy Benefit Companies Support Rural Independent Pharmacies

Pharmacies are important points of care for many patients across the U.S. This can especially be true for patients in rural areas, who may depend on their pharmacist for clinical services—such as vaccinations and help managing chronic conditions—in addition to filling their prescriptions.

Mail-Service Pharmacy

Mail-Service Pharmacies provide a convenient, reliable and affordable option for patients to safely access prescription drugs.

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Specialty
Pharmacies

Payer-aligned specialty pharmacies have the technology and clinical experience to enhance the safety of patients receiving specialty medications.

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