Frequently Asked Questions (FAQs)

1) How is PharmMD different than a Pharmacy Benefit Manager (PBM)?

• PharmMD combines medical and pharmacy data to create a comprehensive electronic patient health record.
• We identify and note problems after the pharmacy fills the drug, including any error that is overridden by the filling pharmacy.
• Our pharmacists also identify gaps in care such as HEDIS gaps and other clinical procedures that should be performed based on a patient’s medical condition and medications.
• We go beyond identifying missed fills and drug-to-drug interactions. We also identify missing medications, incorrect doses, missing tests or inappropriate drugs, and polypharmacy.
• Our nationwide network of pharmacists resolves problems by phone or face to face.
• PharmMD guarantees you will save on medical and pharmacy spending.

2) My PBM currently offers drug therapy programs. How are they different from yours?

• Many PBMs offer step therapy programs around formulary design. When these programs are in place and working, PharmMD rules do not trigger.
• Since PharmMD reviews both medical and pharmacy data, we find many opportunities that are missed by PBM programs.

3) How is the PBM’s use of medical and pharmacy data different than how PharmMD uses it?

• PharmMD focuses on reaching out to the individual and their prescriber to solve the problem. The PBM may lack the resources or the business model to perform aggressive outreach to resolve clinical problems beyond the refill.

4) How do you deal with turnover?

• People need to be enrolled with the plan for at least six months in order to be counted in our results.

5) How do you get results from people that are hard to reach (e.g. truck drivers, hospital shift workers, etc.)?

• We make three attempts at different times and on different days.
• We also send out letters with medication actions plans that the individual can discuss with their prescriber.
• Our outreach is also to the prescribers themselves, where much of the change occurs with a hard-to-reach population.

6) How do you integrate with my Wellness, Disease Management and Care Management providers?

• PharmMD identifies the types of programs already in place and the specific scope of work performed by each provider.
• There are programs that are complimentary to what we offer, performing outreach that can enhance the resolution of our identified rules and potentially reach individuals who have not responded to PharmMD outreach.