More on PBM Marketing (FROM PHARMACY BEST PRACTICES, NOV. 2007)

With transparency becoming a given, pharmacy benefit managers (PBMs) have taken a new approach to marketing their services. The primary marketing/sales strategy for Express Scripts, headquartered in St. Louis, is direct sales with a reliance on intermediary consultants and advisors.

The PBM, however, doesn't bank on demographics, but rather sells its assets. Express Scripts, one of the largest PBMs in the country and an independent, emphasizes an educational approach. By educating its potential clients through seminars, conferences, original research on cost drivers and peer-reviewed journal articles, Express Scripts ensures they have enough information to make a good decision.

Joe Eschbacher, senor director, strategic relationship services, says the company will start marketing more aggressively what he considers to be a key differentiator-focusing on the drug mix so that purchasers can realize the lowest net cost.

The company drives quantifiable value and as an independent PBM, avoids conflicts of interest between the revenue stream and cost management.

MARKETING KNOW HOW

Ensuring transparency in a relationship with a PBM, not surprisingly, is the number one issue for most insurers. PBMs offer more advice about what other issues insurers should consider if they are planning to outsource their pharmacy benefits.

The biggest question for clients should be whether a PBM's incentives are aligned with the plan sponsor or plan, says Steve Meholic, president of the Aetna Health PBM.

Byron Mickle, senior vice president, sales, marketing and client services for Navitus Health Solutions, a PBM based in Madison, Wisc., stresses the importance of developing a clinical strategy rather than focusing on rebates.

"There is a lot of money left on the table by not realizing clinical opportunities offered by PBMs," he says, "as well as taking advantage of better buying power."

CIGNA's Chief Medical Officer Claire Marie Burchill, MD, warns plans to search for a PBM that supports integrated data and can deliver total health outcomes.

"You have to take a holistic approach-delivering the right care at the right time at the right place," she says.

"Insurers should be careful to compare apples to apples for prices and programs," adds Kristi Meyer, vice president, marketing and product development, at WellPoint NextRx. "Be attentive to details so that all promised services are delivered. We partner with our clients, listening to their needs and developing tailored solution."

With consolidation in the PBM industry, Jim Hartert, MD, chief medical officer and senior vice president, Prime Therapeutics, Egan, Minn., believes that the pickings are getting slimmer, which makes it more difficult for insurers who want to outsource their PBM services. "It's not a casual decision to outsource; potential clients need a broker or consultant and need to present an request for proposal," he says. "Clients have to look at the scope of services, operations, philosophy, expertise and direction of the PBM to make the best decision.

"Selecting a PBM was easier when it was primarily based on cost but now the emphasis is on utilization, compliance and specialty pharmacy," he adds.