Pharmacy Benefit Managers
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Questions and Answers

What is the main strategy recommended to inform and influence physician behavior?

  • Using comparative prescribing and utilization data (correct)
  • Conducting large-scale medical trials
  • Relying on drug companies' promotions
  • Increasing marketing efforts

What is the initial focus of P&T committees when selecting drugs for formulary?

  • Cost-effectiveness for patients
  • Popularity among physicians
  • Safety and efficacy determined by the FDA (correct)
  • Reputation of the drug company

What is the goal when selecting drug products for formulary?

  • To follow physician preferences
  • To provide safe and effective medications that achieve desired outcomes (correct)
  • To promote new drugs in the market
  • To increase the revenue of the drug company

Why is it important to use peer-reviewed publications as a source of information when selecting drugs?

<p>To prevent drug companies from influencing decisions (D)</p> Signup and view all the answers

What is a good practice when critically reviewing an article related to drug selection?

<p>Look at the funding agency behind the research (B)</p> Signup and view all the answers

What is the primary responsibility of the Pharmacy and Therapeutics (P&T) Committee?

<p>Developing and updating the formulary (C)</p> Signup and view all the answers

What is one key reason manufacturers are willing to lower prices in exchange for formulary inclusion?

<p>To ensure their drugs are available in hospitals (A)</p> Signup and view all the answers

Who primarily makes up the Pharmacy and Therapeutics (P&T) Committee?

<p>Pharmacists only (B)</p> Signup and view all the answers

What role do physicians play in the P&T Committee?

<p>Giving the committee credibility (D)</p> Signup and view all the answers

What was the primary goal of cost containment in the 1980s-1990s managed care organizations?

<p>Reducing cost (A)</p> Signup and view all the answers

What approach did early pharmacy benefit management take to control costs?

<p>Isolated pharmacy costs and chose the lowest price products (B)</p> Signup and view all the answers

What organization recommends policy to the medical staff on therapeutic drug use?

<p>American Society of Health System Pharmacy (B)</p> Signup and view all the answers

Why might choosing the lowest cost drug not always be valid in healthcare?

<p>Low-cost drugs may have high-cost side effects (D)</p> Signup and view all the answers

Why do manufacturers pay rebates to PBMs?

<p>To get included in the hospital formulary (C)</p> Signup and view all the answers

What is the risk associated with the lower cost drug with high-cost side effects?

<p>Re-hospitalization and relapses (C)</p> Signup and view all the answers

Why are costs considered interdependent in separate components of healthcare (physician, hospital, pharmacy, etc.)?

<p>Costs of one component can affect costs of others (B)</p> Signup and view all the answers

What is the key limitation of cost minimization in separate components of healthcare according to the text?

<p>Interdependent costs (A)</p> Signup and view all the answers

Which of the following is NOT a determinant of formulary consideration?

<p>Accessibility (A)</p> Signup and view all the answers

What does a wide margin of safety imply?

<p>Low risk of side effects (A)</p> Signup and view all the answers

In formulary consideration, what does effectiveness refer to?

<p>The drug's performance under real-life conditions (B)</p> Signup and view all the answers

When considering drug efficacy, what is a key question to ask regarding innovation?

<p>Is the drug a truly innovative product or a 'me too' drug? (C)</p> Signup and view all the answers

What is an important aspect to consider about the side effect profile of a drug?

<p>Fewer and milder side effects are preferred (B)</p> Signup and view all the answers

Why do PBMs negotiate rebates with drug companies?

<p>To generate revenue for the PBM (D)</p> Signup and view all the answers

In the context of formularies, what does a 'closed' formulary mean?

<p>Only drugs on the formulary are covered (C)</p> Signup and view all the answers

How do PBMs benefit from having more restrictive formularies?

<p>By potentially receiving higher rebates (B)</p> Signup and view all the answers

What role do rebates play in the relationship between PBMs and drug manufacturers?

<p>Rebates act as a revenue stream for the PBM (A)</p> Signup and view all the answers

Why do PBMs prefer to have drugs on a 'partially closed' formulary?

<p>To generate higher rebates from drug companies (B)</p> Signup and view all the answers

What is the main reason that restrictive formularies can lead to better rebates?

<p>To channel patients towards certain drugs (D)</p> Signup and view all the answers

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