Pharmacy Benefit Managers

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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?

To prevent drug companies from influencing decisions Signup and view all the answers

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

Look at the funding agency behind the research Signup and view all the answers

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

Developing and updating the formulary Signup and view all the answers

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

To ensure their drugs are available in hospitals Signup and view all the answers

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

Pharmacists only Signup and view all the answers

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

Giving the committee credibility Signup and view all the answers

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

Reducing cost Signup and view all the answers

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

Isolated pharmacy costs and chose the lowest price products Signup and view all the answers

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

American Society of Health System Pharmacy Signup and view all the answers

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

Low-cost drugs may have high-cost side effects Signup and view all the answers

Why do manufacturers pay rebates to PBMs?

To get included in the hospital formulary Signup and view all the answers

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

Re-hospitalization and relapses Signup and view all the answers

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

Costs of one component can affect costs of others Signup and view all the answers

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

Interdependent costs Signup and view all the answers

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

Accessibility Signup and view all the answers

What does a wide margin of safety imply?

Low risk of side effects Signup and view all the answers

In formulary consideration, what does effectiveness refer to?

The drug's performance under real-life conditions Signup and view all the answers

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

Is the drug a truly innovative product or a 'me too' drug? Signup and view all the answers

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

Fewer and milder side effects are preferred Signup and view all the answers

Why do PBMs negotiate rebates with drug companies?

To generate revenue for the PBM Signup and view all the answers

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

Only drugs on the formulary are covered Signup and view all the answers

How do PBMs benefit from having more restrictive formularies?

By potentially receiving higher rebates Signup and view all the answers

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

Rebates act as a revenue stream for the PBM Signup and view all the answers

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

To generate higher rebates from drug companies Signup and view all the answers

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

To channel patients towards certain drugs Signup and view all the answers