AbaPhathi beZibonelelo eziPhakamileyo ze-Pharmacy (PBMs) kunye nendlela abaSebenza ngayo

Umphathi we-pharmacy benefit, owaziwa ngokuba yi-PBM, ngumbutho onika iinkonzo, iinkqubo zemfundo kunye neenkonzo ukunceda izigulane. Benza oku ngokuchaphazela ukuziphatha kwee-pharmist kunye noogqirha ukuba banikeze iziyobisi ngokufanelekileyo ukwenzela ukuba benze ngcono ukusebenza kwabo.

I-PBM ngumlamli phakathi kwabashurensi kunye namanye amalungu enkampu yezempilo. Ngenxa yobungakanani babo, banokuthintana neenkontileka ezinkulu zabathengi kwaye baxoxisana kunye neefommesi kunye neenkampani zonyango ukuze bafumane amaxabiso angcono.

Amalungu omsebenzi wekhemisti kufuneka azi ukuba yiyiphi i-PBM elawula iimarike, iinkampani ezinkulu kakhulu zinomlinganiselo omkhulu wokuxoxisana namazinga okubuyisela amayeza kunye neenkonzo zokunyamekela isigulane.

Iimbopheleleko zePBM

Kungakunceda ukucinga nge-PBM njengomntu ophakathi kwenkqubo yokunakekelwa kwezempilo. Ingathatha isicwangciso esihle sokucwangcisa kunye nomsebenzi wokufumana imithi oyifunayo kuwe ngexesha. Ngokubhekiselele, i-PBM inomsebenzi omkhulu, kuquka:

Njengoko ubona, ii-PBM zinemisebenzi eninzi ejongene nokunyamekela.

Iinkampani ezinhlanu ezinkulu kakhulu zePBM

Ii-PBM ezinhlanu ezinkulu ezisebenza eUnited States zikhulu kakhulu, zibandakanya ngaphezu kwama-50 ekhulwini kwezigulane ezineenzuzo zoshishino. Ezi zilandelayo zi-five PBM ezinkulu kwilizwe, ngokwemali kunye nokukhula:

  1. I-ExpressScripts: I-ExpressScripts inikezela izisombululo ezinje zokuhamba ngeendleko ze-pharmacy nokuphucula ukunakekelwa kwezigulane. Ekubeni i-ExpressScripts ayinayo okanye inxulumene nayo nayiphi na inkampani yezobisi, ukugxila kwabo kubathengi bayo. Ukugxininiswa kwimivuzo ye-pharmacy kubangela ukhathalelo olungcono lwezonyango.
  2. I-CVS Caremark: I-CVS Caremark yi-PBM ekhulayo, ukubonelela ngeenkonzo ezixhamlileyo zonyango kwi-2,000 abaxhasi bezempilo kunye nabathathi-nxaxheba kulo lonke elaseMerika.
  3. Argus: Argus ungomnye wabanikezeli bokugqibela abazimeleyo ngolwazi lwezempilo kunye neenkonzo ezixhasa i-Medicaid ne-Medicare Part D, zikhonza ezinye zeendawo ezikhuselekileyo. Banobubanzi obuninzi beethengi, kwimibutho yokunyamekela ephethwe kubavelisi bamachiza.
  4. Cinga ngolu hlobo: Ukujonga izinto ezibonakalayo ngokuzibonakalisa ngokubonakalayo kuluntu kunye nokudalulwa kwayo ngokupheleleyo kwiindleko, izivumelwano kunye nothethwano. Kungekudala, Ukucinga bekufumene iWalgreens, ngoko utshintsho olulindelekileyo luya phambili.
  5. ProCare RX: ProCare RX ngumphathi welizwe loxanduva lwe-pharmacy ngamava eminyaka ekhompyutheni yolwazi lwezempilo.

Inkqubo yokunakekelwa kwezempilo iyinkimbinkimbi kakhulu, kunye neenkampani ezininzi ezichaphazelekayo ezihamba ngaphaya kogqirha nobudlelwane bamachiza.

I-PBM idlala indima ebalulekileyo ekukufumaneni izidakamizwa ozifunayo ngentengo onako ukuyisebenzisa kwaye usebenzise izixhobo zayo ezinkulu ukuxoxisana egameni labagcini bomshuwalense kunye nabathengi.