Data Sales In most PBM agreements, you will find a language that allows a PBM to sell an unidentified data from a customer to a company that then sells it to pharmaceutical companies that use the information to guide their marketing efforts. This unidentified data usually consists of the doctor`s name and medications prescribed to participants in a client`s plan. The sale of unidentified data is quite controversial and some states have taken steps to ban it. The question is whether the customer should receive the economic value of the data sold. Many customers do not want their unidentified data to be sold. In order to address the sale of unidentified data, it is possible to include a language that prohibits PBM from selling unidentified data or allows PBM to sell an unidentified customer`s data with the customer`s written consent, and requires PBM to pay the customer. Navigating the complex world of the PBM contract is never easy. Before you sign a PBM agreement, you need to make sure that certain conditions are included. It is always advisable to seek advice from PBM price experts who are not DES PBMs themselves. As long as you follow these guidelines and seek help where it is needed, you can get the best possible prescription prices for your program participants. The pharmaceutical profit management industry (“PBM”) is now considered one of the most complex health sectors.
PBM customers, whose prescription drug costs continue to rise, are trying to understand how PBMs make consistent record profits by telling their customers that they are saving money. The PBM industry knows that most customers will not understand the intricacies of PBM`s business and will often present a complex and difficult-to-understand contract. However, there are several things a client should consider to protect their interests: definitions of brand name drugs, generic drugs and specialty drugs; Market registration language; Selling unidentified data Performance and price guarantees and what happens when the average wholesale price (AWP) is no longer available as a source of price. Price Guarantees The most important part of a PBM contract is to ensure that the price plan of the PBM agreement accurately reflects the price offer in the RFP.