Trends Affecting Prescription Benefit Management and Spending

COMPREHENSIVE PBM AUDITS

Benefit managers and claims payers in general consider their health benefits, dollars including their prescription benefit spending,  as a valuable asset that must be safeguarded and optimized to ensure their beneficiaries receive the most cost-effective therapies and delivery strategies available.

This white paper discusses important trends affecting prescription benefit spending; the importance of establishing a comprehensive program to review the totality of paid prescription claims against multiple criteria; the challenges inherent in undertaking comprehensive reviews; and how the CTI/CGI approach can provide long-term benefits through a systematic and regular cycle of auditing to optimize review efforts.