PBM Drug Rebates

[@TrestonCal]

Some folks pick insurance plans based on what may / may not be covered on the formulary. When they adjust this formulary prior to the next open enrollment period, this is where a lot of patients are screwed.

[@TheMoneyMakingMentor]

Joey thanks for this valuable information

[@归来少年]

Thanks for sharing

[@pharmacistplace]

Thanks for watching!

[@mahindra9]

Thank you very much. I would be happy to view any more videos on PBM. Please share the links if you know.

[@chinweoparaocha592]

Thank you for this video. What happens when a highly effective drug is too expensive to be put on a PBM formulary?

[@davidlanday6102]

Hi, I was watching this at work so I needed to watch with subtitles and if this question is not fully developed I apologize. What prevents a PBM from becoming a pharmacy when the rebate directly from pharmaceutical company is better than what the Pharmacy is willing to provide?

[@MrSupervan86]

No, you would be responsible for 100% of the cost for Drug B because it is not covered by your PBM nor on their formulary list . A 30/70 chance is to have your pharmacy fax the doctor for a PA (Prior Authorization) or reperscribe for a different drug. The doctor would then need to fax or call the PBM explaining why you can't take Drug A. Some Examples: Step drug therapy, allergic reactions, patient prefers, etc. From there it is up to PBM's to approve or denied.