PBM Overview Pharmacy Benefit Managers (PBMs) work with health insurers, large employers and other payers to manage prescription drug benefits. The initial role of PBMs was to negotiate reimbursement rates with drug manufacturers, manage prescription drug claims, and reimburse pharmacies for dispensed medications. Since its inception, the role of the PBMs have evolved over time…
Cost-Effectiveness Models: A Strategic Tool for Pricing and Market Access In today’s market, clinical efficacy alone is rarely enough to differentiate a product. Payers, health systems, and policy bodies want to know: Is the price justified by the value delivered? Cost-effectiveness modeling provides a structured way to answer that question by connecting clinical outcomes to…
Introduction to Patient Support Services Models A patient support services model is a data-driven tool or framework that helps forecast and analyze the various aspects of manufacturer-sponsored patient support programs. Patient support services models simulate real-world scenarios. They predict how changes in patient needs, insurance policies, program rules, and regulations impact patient support program enrollment, utilization, costs,…