The Employer's Guide Blog for Overseeing PBMs

The Definition of Oversee: to watch over and direct (an undertaking, a group of workers, etc.) in order to ensure a satisfactory outcome or performance.

Study Sheds Light on Concerning New Trend in Drug Advertising [Weekly Roundup]

Study Sheds Light on Concerning New Trend in Drug Advertising and other notes from around the interweb:

  • Top 20 GoodRx Competitors & Alternatives. GoodRx is a leading online platform that helps consumers compare prescription drug prices and offers discounts on their medications. GoodRx is the go-to source for many and is the leading online resource for free prescription drug coupons and discounts. Several of GoodRx’s competitors also provide prescription drug coupons and discounts, such as Blink Health, SingleCare, NeedyMeds, RxSaver, WellRx, Truepill, WeRx, and Optum Perks. Each of these companies offers different services and discounts, so customers research and find the best option for their needs. Here’s a look at top GoodRx competitors and alternatives and how they compare.
  • The CAA will ensure that doing the right thing is the only option. The CAA will soon begin holding employers accountable for upholding their fiduciary responsibility and exploring insurance options that lower the cost of employee health care. Word is circulating that the CAA may allow employees to sue employers if they don’t effectively manage their health care benefits. Even though the idea of employees taking legal action against their employers regarding health care benefits sounds terrible, if this interpretation is correct, it should have a positive effect on the health care industry. Should employers be worried about this new eventuality? No, not all of them. Most employers want to help their people — they just don’t fully understand that they have options. The new CAA guidelines will push employers and their brokers to explore other avenues that lower health care costs. It is simply establishing a framework to protect employees from medical debt — the leading cause of bankruptcy in the United States.
  • How Accumulators and Maximizers May Be Increasing Your Out-of-Pocket Drug Costs. A copay accumulator adjuster program is a type of health insurance program that affects people using biopharmaceutical patient assistance programs, which are usually provided by a drug manufacturer to help reduce the cost of taking the medication. Accumulator programs don’t allow patient assistance through the pharmaceutical industry to count toward the deductible set by the insurance company. For example, let’s say your patient assistance card has a $6,000 limit and your deductible is $6,000. After that $6,000 is covered by the patient assistance program, you still have to pay $6,000 out-of-pocket since none of it was counted toward the deductible with an accumulator adjuster program, per the Global Healthy Living Foundation (GHLF). “It started about five years ago when the pharmacy benefit management companies started introducing the accumulator program marketplace, so they convinced a lot of employers to pick it up as part of their benefit design,” says Robert Popovian, PharmD, Chief Science Policy Officer at GHLF. “But it’s not just about the accumulators. The next iteration is the maximizer program, which is a little different, but the same principle applies.
  • Study Sheds Light on Concerning New Trend in Drug Advertising. The study, published this week in the Journal of Medical Internet Research, provides some of the first insights into the burgeoning, loosely regulated world of so-called “patient influencers,” sharing findings from 26 in-depth interviews about why and how they do it. “The bottom line here is that patient influencers act as a form of interactive direct-to-consumer (DTC) advertising, sharing their knowledge and experiences on pharmaceutical drugs with communities of followers in which they wield great influence,” said author Erin Willis, an associate professor of advertising, public relations, and media design. “This raises ethical questions that need more investigation.” The study comes amid growing concerns about the harmful consequences of drug promotion on social media. In recent weeks, in the wake of a slew of TikTok videos and Twitter posts touting the weight loss benefits of the diabetes drug Ozempic, patients who need the medication to manage their disease have faced global shortages. Meanwhile, those taking it “off-label” to slim down have experienced surprising side-effects, including violent diarrhea and extreme facial thinning. “This is a great example of the power of social media and the unintended consequences,” said Willis.

Tyrone Squires, MBA, CPBS

I am the proud founder and managing director of TransparentRx, a fiduciary-model PBM based in Las Vegas, Nevada. We help health plan sponsors reduce pharmacy spend, by as much as 50%, without cutting benefits or shifting costs to employees.

Leave a Reply