PBM Pressure

What you should be doing to Counteract PBM Pressure

PBM pressure and changes are a daily news report both in the industry news and the general news. But we cannot control the PBMs. Yes we can do legislation, be active in both NCPA and your local state association but this is a long term endeavor.

So what can you do today? Here are our thoughts.

  1. Equipp – you should be signed up and working on the patients that are just under 80%. The more you improve, the less your DIR and GER fees will be. Sign up here.
  2. Med Sync – this is a must do program for retail community pharmacies. It will improve patient compliance, lowering DIR and GER Fees, will increase sales, reduce inventory and lower payroll. All of which help protect against PBM Pressure.
  3. MTMs – you have to do them, they create revenue, improve equipp scores and lower DIR/GER Fees.
  4. Compounding – this service offering operates at high margins and mostly cash. 10 compounds per day will offset most of the PBM reimbursement decline.
  5. Long Term Care – a true LTC service has no fees and better margins. Plus it is hard to compete against an independent in this space.
  6. Daily Dose at Home Packaging – more and more people are home bound or require at home care. Home Health Agencies need your help and will send you business, increasing script count and revenue. Plus in many cases you can charge for the packaging and delivery.
  7. Cross Sell OTC – every other business in the country tries to cross sell you. McDonald’s asks do you want fries with that, Target asks you to get their card. Yet independent pharmacies never ask if you have gotten your flu shot, if you know about vitamins, if you want a candy bar. Doing this will improve margins and increase sales.

At IRx Consulting we are Accounting experts and offer a comprehensive Pharmacy Accounting and Management service with a suite of complimentary services including Data Dashboards, Payroll & Human Resources and Pharmacy Management consulting.

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