US-RX Care

Driven by profit motives, your PBM pushes high-priced drugs despite evidence of often serious side-effects. It is important to understand that your PBM is actually your PBS (Pharmacy Benefit Supplier) dispensing over 80% of your pharmacy benefit spend from their mail and specialty pharmacies. Selecting medications based on their profits. According to a recent article in Health Affairs “Public, independent advisory teams of physicians and pharmacists in several countries found over 90 percent of new drugs approved by the FDA and the European Medicines Agency (EMA) offer few or no advantages over existing drugs to offset their risks of serious harm. Despite those dangers, drugmakers employ full-court press when marketing these new drugs to doctors and PBMs. The sad fact is that dangerous drugs are being prescribed and there is no one who is there to warn your workers about them and offer alternatives. As well, many of these higher-cost pharmaceuticals may not be as effective as more proven and lower-cost medications on the market. That contrasts with US-Rx Care’s approach, which is to prioritize your company’s financial interests AND your employee’s health. You need a Fiduciary Independent Pharmacy Utilization Manager like US-Rx Care. Contact Mark Mincy @ [email protected] to discuss how you can have Better Outcomes and Lower Cost. https://lnkd.in/eEpqKqtP

With a marketplace demanding more, fiduciary PBMs—like US-Rx Care—have become the clear alternative to the status quo. For fiduciary PBMs, who are contractually obligated to act in the best interest of every client, transparency, fairness, trust, and accountability aren’t just buzzwords that marketers throw around—they are guarantees. But what does that mean for you? Click the link in comments to read the full blog! #PBM #Fiduciary #PharmacyBenefits

Chronic health conditions are a growing problem for workers, damaging their well-being, productivity and job satisfaction, according to a new study. According to the study, 58% of U.S. employees report having a physical chronic health condition such as hypertension, heart disease, diabetes or asthma. Among them, 76%?need to manage their condition during work hours, yet 60% have never formally disclosed their health issues to their employer. This lack of disclosure can create issues for both the employer and worker, affecting productivity, job satisfaction and overall workplace well-being. https://lnkd.in/gbCpHjrX

Same Drug, Two Prices: Why the Higher Price Prevails While there are price disparities and cheaper options for many drugs, your PBM may be pushing the higher priced version due to the money they collect from PhRMA and which is not included in your rebate payments.?Remember, your PBM is really your PBS (Pharmacy Benefit Supplier) now that they dispense over 80% of your pharmacy benefit plan spend from their own mail and specialty pharmacies. Selecting drugs based on their profits. Why does your PBM continue to push these high-cost medications with no clinical advantage over more proven and lower-priced drugs? Profits! And, if your consultant allows your PBM to prioritize these high-cost medications, ask them how much money they receive from your PBM that is directly and indirectly related to your PBM contract. This attestation is a requirement of the CAA regulation. You need a Fiduciary Independent Pharmacy Utilization Manager like US-Rx Care. Contact Mark Mincy @ [email protected] to discuss how you can have Better Outcomes and Lower Cost. https://lnkd.in/eVFUSe5t

In a recent episode of The ShiftShapers Podcast, US-Rx Care President Renzo Luzzatti joined host David Saltzman to explore the complex world of Pharmacy Benefit Managers (PBMs) and their impact on healthcare costs. Renzo discusses the Consolidated Appropriations Act, which is aimed at shifting power back to payers from vendors by enhancing transparency and fiduciary responsibilities. Click the link in the comments to listen to the full episode! #PBM #Fiduciary #PharmacyBenefits

Who is watching out for the well-being of your employees and their families? Don’t Depend on your PBM that is basing clinical decisions on profits from dispensing medications from their mail and specialty pharmacies! Realize, your PBM is really your PBS (Pharmacy Benefit Supplier) now that they dispense over 80% of your pharmacy benefit cost from their own mail and specialty pharmacies. Selecting drugs based on their profits. Unsafe medications, including opioids, were marketed by PhRMA companies in spite of their dangers and doctors prescribed these medications thanks to schmoozing by PhRMA, including lavish gifts to doctors and all expenses-paid seminars on their drugs.?Additionally, many of these medications may not be as effective as lower-cost medications with track records of efficacy. Now some of these same drugs are being pulled due to the dangers they present to patients, according to this article. You need a Fiduciary Independent Pharmacy Utilization Manager like US-Rx Care. Contact Mark Mincy @ [email protected] to discuss how you can have Better Outcomes and Lower Cost. https://lnkd.in/g2bxDdCD

The CMS has floated proposed regulations that would allow Medicare drug plans and Medicaid to cover GLP-1 diabetes and weight-loss drugs. If the rules become permanent, market watchers expect group health insurers to do the same. Here's a look at how that may work and if it would drive up health insurance costs. https://lnkd.in/gbtpu3XA

Each year, mental health issues such as depression and anxiety lead to a staggering 12 billion missed workdays globally, according to a new study by Resolute Psychiatry, an online platform that provides virtual counseling. The compounding effects of these mental health challenges — fatigue, poor concentration, detachment, stress and physical symptoms — are obviously a serious challenge for businesses. Fortunately, there are steps that companies can take to provide mental health support in the workplace. https://lnkd.in/g-wsXRTX

An excerpt from the recent House Oversight Committee PBM Report cites a University of Southern California study from 2015 – 2018 which found that for every $1 increase in rebates there was a corresponding increase in drug list prices. The study found a?direct correlation between rebate increases and manufacturer price increases: a?$1 increase in rebates corresponded with a $1.17 increase in drug list price, “suggest[ing] that rebates do play a role in increasing list prices.” Based on levels of inflation in the last few years, it’s likely the markup has risen since then.

With the Medicare Part D members’ maximum out-of-pocket being brought down to $2,000 starting in 2025, is your Part D program prepared for this massive increase in liability? ? Faced with covering 60% of any plan participant’s annual drug spend beyond that, can you afford to depend on your PBM to manage this surge in spending? ? Our proven cost optimization program typically provides $20-$30 pmpm gross savings with no member disruption, no change in PBM and no change benefit changes. ? Please contact Mark Mincy at:?[email protected]?to schedule a meeting.