Adding a Pharmacy Benefit Management (PBM) program component to an employer's cost reduction program is a necessity. Drug costs are the fastest growing component of medical care and often one of the most neglected areas of workers compensation cost control.
There are numerous pharmacy benefit managers (PBM) in the workers compensation arena that insurers, self-insureds, and third party administrators (TPA) can work with. Other areas of medical cost control like fee bill schedules, medical provider networks, medical management, and utilization review get more attention than PBM, but proper utilization of PBM can result in substantial savings.
Many risk managers think of PBM only as a way of saving money by getting a discount on the cost of prescriptions. However, if the insurer (or the self-insured employer who is paying attention to the factors in the cost of their workers compensation coverage) shops around they can locate a PBM focusing on utilization control. Look for utilization management and cost management components.
Remember: There is NO co-pay for workers compensation medications.
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